Abstract
ObjectivesTo summarize the clinical characteristics of post-traumatic epilepsy (PTE), and to identify the factors affecting the latency of PTE after traumatic brain injury (TBI).MethodsWe conducted a retrospective clinical analysis in patients with PTE who visited the outpatient Department of Epilepsy, Beijing Tiantan Hospital from January 2013 to December 2018. The clinical characteristics, including gender, age distribution, seizure type, and latency were summarized. Factors affecting the latency of PTE were evaluated using Kaplan-Meier curves and Cox proportional hazard regression analysis.ResultsComplete clinical information was available for 2862 subjects, of which 78.48% were males. The mean age at TBI was 21.4 ± 15.1 years and peaked in the 0 to 12-year-old and 15 to 27-year-old groups. Generalized onset seizure was the most frequent seizure type (72.82% of patients). Approximately 19.95% PTE patients developed drug-resistant epilepsy. The latency of PTE ranged from 8 days to 20 years, with a median of 24.0 (IQR, 5.0–84.0) months. The Kaplan-Meier curves demonstrated that gender, age at TBI, severity of TBI, multiple craniocerebral injuries, post-TBI treatments, acute seizures, and residual disability were associated with PTE latency. The Cox regression model indicated that age ≥ 18 years old, severe TBI with multiple surgical operations, acute seizures, and residual disability were risk factors for shorter PTE latency.ConclusionsPTE is more common in males than females, and peaked in the 0 to 12-year-old and 15 to 27-year-old groups. Generalized onset seizure was the most common seizure type and 19.95% of participants developed drug-resistant epilepsy. Patients aged ≥18 years old, who suffered severe TBI followed by multiple surgical operations, experienced acute seizures, or with residual disabilities had shorter PTE latency.
Highlights
Traumatic brain injury (TBI) is a common public health concern
The results showed that age ≥ 18 years, severe TBI followed by multiple surgical operations, presence of acute seizures, and residual disability after TBI were risk factors for shorter latency, while severe TBI followed by conservative treatments was a protective factor
The current study enrolled 2862 participants diagnosed with post-traumatic epilepsy (PTE), summarized the clinical characteristics of PTE, and found that age at TBI, severity of TBI, post-TBI treatments, acute seizures, and residual disability were independent factors affecting the latency of PTE, thereby providing a reference point for survivors of TBI when making therapeutic decisions
Summary
Traumatic brain injury (TBI) is a common public health concern. Post-traumatic epilepsy (PTE) is one of the most common and disabling sequela of TBI, defined as repeated unprovoked seizures seven days after TBI. The incidence of PTE in the civilian population following TBI is 2 to 17%, and is correlated with the severity of TBI (mild TBI: 2.1%; moderate TBI: 4.2%; severe TBI: 16.7%) [3,4,5,6,7,8]. Among military patients with penetrating TBI, the incidence of PTE is significantly higher, at 22 to 53% [6]. In terms of composition ratio, PTE accounts for 5% of epilepsy cases and 20% of symptomatic epilepsy cases [6, 9]
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