Epilepsy: mild brain trauma can increase epilepsy risk

6 March 2009

Children and young adults who experience mild traumatic brain injuries have an increased risk of developing epilepsy for as long as 10 years after the injury.

A comparison of Danish birth and hospital records for people born between 1977 and 2002 found those who had a mild brain injury had more than twice the risk of subsequently developing epilepsy as those with no injury (Lancet 2009, online 23 February).

Mild brain injury was defined as concussion resulting in loss of consciousness, amnesia (lack or loss of memory), confusion or disorientation, or temporary focal neurological deficit (a problem in nerve function that affects a specific function or specific location in the body).

Their risk of epilepsy remained 50 per cent higher than those without brain injury for up to 10 years after the injury was sustained.

Risk of epilepsy was 7 times higher after severe brain injury.

Patients with a family history of epilepsy had a higher risk after mild or severe brain injury.

The authors said while prophylactic (preventive) drug treatment after brain injury to prevent epilepsy had been discouraging, their data suggested a long time interval for potential, preventive treatment for high-risk patients.

Professor Terry O’Brien, head of the epilepsy programme at Royal Melbourne Hospital, said the study clarified conflicting data regarding the risks associated with mild brain trauma.

He agreed the results provided a rationale for why prophylactic treatment was needed, but said unfortunately there was currently no such treatment available.

‘Antiepileptic drugs are not antiepileptogenic,’ he said. ‘They prevent seizures from occurring while you are taking the drug. As soon as you stop, you are as likely to have a seizure as if you never took it in the first place.’


 
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