Risk factors for posttraumatic epilepsy: A systematic review and meta-analysis |
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| Institution: | 1. Laboratory of Neuro Imaging, USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA;2. Division of Neurosurgery and Department of Neurology, University of California at Los Angeles School of Medicine, Los Angeles, CA, USA;3. A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland;1. Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA, United States;2. Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, United States;3. Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA, United States;4. Department of Neuroscience, University of Pittsburgh, Pittsburgh, PA, United States;5. Center for Neuroscience at University of Pittsburgh, Pittsburgh, PA, United States;6. University of Alabama at Birmingham Department of Neurology and UAB Epilepsy Center, Birmingham, AL, United States;7. Dept of Physical Medicine & Rehabilitation, Virginia Commonwealth University, Richmond, VA, United States;8. Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Brigham and Women''s Hospital, Harvard Medical School, Boston, MA, United States;9. Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, United States;10. Carolinas Rehabilitation, Charlotte, NC, United States;11. Indiana University School of Medicine, Indianapolis, IN, United States;12. South Texas Veterans Health Care System Polytrauma Rehabilitation Center, San Antonio, TX, United States;13. Department of Epidemiology and Biostatistics, University of Texas Health Science Center San Antonio, San Antonio, TX, United States;14. Department of Physical Medicine and Rehabilitation, Ohio State University, Columbus, OH, United States;15. Department of Neurology, Columbia University Medical Center, New York, NY, United States |
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| Abstract: | ObjectiveA systematic review and meta-analysis was performed to identify risk factors for posttraumatic epilepsy (PTE).MethodsTwo electronic databases (Medline and Embase) were searched to identify studies with a cohort, case-control, or cross-sectional design reporting on epidemiologic evidence regarding risk factors for PTE.ResultsMen had a higher risk of developing PTE than women relative ratio (RR), 1.32; 95% confidence interval (CI), 1.10–1.59]. A history of alcohol abuse (RR, 2.18; 95% CI, 1.26–3.79), posttraumatic amnesia (RR, 1.31; 95% CI, 1.12–1.53), focal neurologic signs (RR, 1.42; 95% CI, 1.16–1.74), and loss of consciousness at initial traumatic brain injury (TBI) (RR, 1.62; 95% CI, 1.13–2.32) were associated with a greater risk of PTE. TBI-related abnormal neuroimaging findings, including skull fracture (RR, 2.27; 95% CI, 1.49–3.44), midline shift (RR, 1.46; 95% CI, 1.14–1.87), brain contusion (RR, 2.35; 95% CI, 1.69–3.28), subdural hemorrhage (RR, 2.00; 95% CI, 1.33–3.01), and intracranial hemorrhage (RR, 2.65; 95% CI, 1.83–3.82) were strong risk factors for PTE. The risk of developing PTE after skull fracture, mild brain injury, and severe brain injury peaked within the first year after TBI, and then gradually decreased. However, a high risk of PTE was sustained for > 10 years.ConclusionThe current meta-analysis identified potential risk factors for PTE. The results may contribute to better prevention strategies and treatments for PTE. |
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