TY  - JOUR
PY  - 2019//
TI  - Early seizures and temporal lobe trauma predict post-traumatic epilepsy: a longitudinal study
JO  - Neurobiology of disease
A1  - Tubi, Meral A.
A1  - Lutkenhoff, Evan
A1  - Blanco, Manuel Buitrago
A1  - McArthur, David L.
A1  - Villablanca, Pablo
A1  - Ellingson, Benjamin
A1  - Diaz-Arrastia, Ramon
A1  - Van Ness, Paul
A1  - Real, Courtney
A1  - Shrestha, Vikesh
A1  - Engel, Jerome
A1  - Vespa, Paul M.
A1  - Agoston, Denes
A1  - Au, Alicia
A1  - Bell, Michael J.
A1  - Branch, Craig A.
A1  - Buitrago Blanco, Manuel
A1  - Bullock, Ross
A1  - Claassen, Jan
A1  - Clarke, Robert
A1  - Cloyd, James
A1  - Coles, Lisa
A1  - Crawford, Karen
A1  - Diaz-Arrastia, Ramon
A1  - Duncan, Dominique
A1  - Ellingson, Benjamin
A1  - Engel, Jerome
A1  - Foreman, Brandon
A1  - Galanopoulou, Aristea
A1  - Gilmore, Emily
A1  - Olli, Grohn
A1  - Harris, Neil
A1  - Hartings, Jed
A1  - Lawrence, Hirsch
A1  - Hunn, Martin
A1  - Jetté, Nathalie
A1  - Johnston, Leigh
A1  - Jones, Nigel
A1  - Kanner, Andres
A1  - McArthur, David L.
A1  - Monti, Martin
A1  - Morokoff, Andrew
A1  - Moshe, Solomon
A1  - Mowrey, Wenzhu
A1  - Naughton, Tomas
A1  - O'Brien, Terence
A1  - O'Phelan, Kristine
A1  - Pitkänen, Asla
A1  - Raman, Rema
A1  - Robertson, Courtney
A1  - Rosenthal, Eric
A1  - Shultz, Sandy
A1  - Snutch, Terrance
A1  - Staba, Richard
A1  - Toga, Arthur
A1  - Van Horn, Jack
A1  - Vespa, Paul
A1  - Willyerd, Frederick
A1  - Zimmermann, Lara
SP  - 115
EP  - 121
VL  - 123
IS  -  
N2  - 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>
LA  - en
SN  - 0969-9961
UR  - http://dx.doi.org/10.1016/j.nbd.2018.05.014
ID  - ref1
ER  -