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Post-Traumatic Epilepsy Can Occur Years After Brain Injury

Last Updated: July 19, 2010.

Some soldiers who suffered penetrating head injuries in the Vietnam War developed post-traumatic epilepsy more than 14 years after receiving their injuries, and the location, size, and type of lesion all predict post-traumatic epilepsy, according to the latest phase of the decades-long Vietnam Head Injury Study reported in the July 20 issue of Neurology.

MONDAY, July 19 (HealthDay News) -- Some soldiers who suffered penetrating head injuries (PHIs) in the Vietnam War developed post-traumatic epilepsy (PTE) more than 14 years after receiving their injuries, and the location, size, and type of lesion all predict PTE, according to the latest phase of the decades-long Vietnam Head Injury Study (VHIS) reported in the July 20 issue of Neurology.

V. Raymont, of the National Naval Medical Center in Bethesda, Md., and colleagues in the VHIS have followed 1,221 Vietnam War veterans with mostly PHIs and a high prevalence of PTE for years. In phase 3 of the study, the researchers conducted neurologic, cognitive, behavioral, and brain imaging evaluations on 199 veterans and a control group of uninjured subjects 30 to 35 years after injury to identify PTE trends.

The researchers found that 87 subjects (43.7 percent) had seizures, which was similar to the 53 percent prevalence found in phase 2 evaluations of 520 subjects 20 years earlier. Most commonly, these were complex partial seizures (31.0 percent), with increasing frequency after injury. The phase 3 evaluations identified 11 subjects (12.6 percent) who had developed very late onset PTE since their phase 2 evaluation and more than 14 years after their injury. This subset of patients did not exhibit different characteristics from patients with earlier-onset PTE. In regression analysis, left parietal lobe lesions and ferric metal fragments remaining in the brain were associated with PTE, and loss of brain volume predicted seizure frequency.

"Patients with PHI carry a high risk of PTE decades after their injury, and so require long-term medical follow-up," the authors write.

One study author reported being chief executive officer and chairman of Oncovir Inc., in which he owns stock. Two authors reported holding medical patents.

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