@article{ref1,
title="Early seizures and temporal lobe trauma predict post-traumatic epilepsy: a longitudinal study",
journal="Neurobiology of disease",
year="2019",
author="Tubi, Meral A. and Lutkenhoff, Evan and Blanco, Manuel Buitrago and McArthur, David L. and Villablanca, Pablo and Ellingson, Benjamin and Diaz-Arrastia, Ramon and Van Ness, Paul and Real, Courtney and Shrestha, Vikesh and Engel, Jerome and Vespa, Paul M. and Agoston, Denes and Au, Alicia and Bell, Michael J. and Branch, Craig A. and Buitrago Blanco, Manuel and Bullock, Ross and Claassen, Jan and Clarke, Robert and Cloyd, James and Coles, Lisa and Crawford, Karen and Diaz-Arrastia, Ramon and Duncan, Dominique and Ellingson, Benjamin and Engel, Jerome and Foreman, Brandon and Galanopoulou, Aristea and Gilmore, Emily and Olli, Grohn and Harris, Neil and Hartings, Jed and Lawrence, Hirsch and Hunn, Martin and Jetté, Nathalie and Johnston, Leigh and Jones, Nigel and Kanner, Andres and McArthur, David L. and Monti, Martin and Morokoff, Andrew and Moshe, Solomon and Mowrey, Wenzhu and Naughton, Tomas and O'Brien, Terence and O'Phelan, Kristine and Pitkänen, Asla and Raman, Rema and Robertson, Courtney and Rosenthal, Eric and Shultz, Sandy and Snutch, Terrance and Staba, Richard and Toga, Arthur and Van Horn, Jack and Vespa, Paul and Willyerd, Frederick and Zimmermann, Lara",
volume="123",
number=" ",
pages="115-121",
abstract="OBJECTIVE: Injury severity after traumatic brain injury (TBI) is a well-established risk factor for the development of post-traumatic epilepsy (PTE). However, whether lesion location influences the susceptibility of seizures and development of PTE longitudinally has yet to be defined. We hypothesized that lesion location, specifically in the temporal lobe, would be associated with an increased incidence of both early seizures and PTE. As secondary analysis measures, we assessed the degree of brain atrophy and functional recovery, and performed a between-group analysis, comparing patients who developed PTE with those who did not develop PTE. <br><br>METHODS: We assessed early seizure incidence (n = 90) and longitudinal development of PTE (n = 46) in a prospective convenience sample of patients with moderate-severe TBI. Acutely, patients were monitored with prospective cEEG and a high-resolution Magnetic Resonance Imaging (MRI) scan for lesion location classification. Chronically, patients underwent a high-resolution MRI, clinical assessment, and were longitudinally monitored for development of epilepsy for a minimum of 2 years post-injury. <br><br>RESULTS: Early seizures, occurring within the first week post-injury, occurred in 26.7% of the patients (n = 90). Within the cohort of subjects who had evidence of early seizures (n = 24), 75% had a hemorrhagic temporal lobe injury on admission. For longitudinal analyses (n = 46), 45.7% of patients developed PTE within a minimum of 2 years post-injury. Within the cohort of subjects who developed PTE (n = 21), 85.7% had a hemorrhagic temporal lobe injury on admission and 38.1% had early (convulsive or non-convulsive) seizures on cEEG monitoring during their acute ICU stay. In a between-group analysis, patients with PTE (n = 21) were more likely than patients who did not develop PTE (n = 25) to have a hemorrhagic temporal lobe injury (p < 0.001), worse functional recovery (p = 0.003), and greater temporal lobe atrophy (p = 0.029). <br><br>CONCLUSION: Our results indicate that in a cohort of patients with a moderate-severe TBI, 1) lesion location specificity (e.g. the temporal lobe) is related to both a high incidence of early seizures and longitudinal development of PTE, 2) early seizures, whether convulsive or non-convulsive in nature, are associated with an increased risk for PTE development, and 3) patients who develop PTE have greater chronic temporal lobe atrophy and worse functional outcomes, compared to those who do not develop PTE, despite matched injury severity characteristics. This study provides the foundation for a future prospective study focused on elucidating the mechanisms and risk factors for epileptogenesis.<br><br>Copyright © 2017. Published by Elsevier Inc.<p /> <p>Language: en</p>",
language="en",
issn="0969-9961",
doi="10.1016/j.nbd.2018.05.014",
url="http://dx.doi.org/10.1016/j.nbd.2018.05.014"
}