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New study finds that traumatic epilepsy following head trauma can develop years later

A new study published in this week’s medical journal, Neurology (July 20 issue) finds that traumatic epilepsy can develop years after brain trauma takes place.

"Not only do combat veterans with a penetrating traumatic brain injury have high rates of epilepsy, but the development of epilepsy can occur decades after their lesion," said lead researcher Jordan Grafman, a senior investigator at the U.S. National Institute of Neurological Disorders and Stroke.

Equally disturbing is the finding that even when epilepsy  develops soon after their brain injury, the seizures can become more severe over time.
 
The report evaluated  199 Vietnam War veterans who had had a penetrating brain injury about 35 years earlier. The veterans were given intelligence tests and brain scans to uncover lesions.

The researchers found that 87 veterans had developed post-traumatic epilepsy. In 11 cases, it took more than 14 years for the epilepsy to show up.

In some cases, the type of seizure changed over time, often becoming more severe or causing loss of consciousness, the team discovered.

Among young adults, post-traumatic epilepsy is the most common cause of new epilepsy, with almost 30,000 new cases diagnosed each year in the United States, the researchers pointed out.

"Post-traumatic epilepsy can be a chronic issue after traumatic brain injury and can affect cognitive and social functions as combat vets age," Grafman said. "Consideration needs to be given to providing combat veterans with TBI [traumatic brain injury] careful and routine evaluations for epilepsy," he added.

Dr. L. James Willmore, co-author of an accompanying journal editorial, said this report and earlier studies point out several risk factors for epilepsy, including brain volume loss from the trauma, metal fragments that remain within the brain, and the presence of a hematoma associated with the initial injury.

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