Subtypes of Post-Traumatic Epilepsy: Clinical, Electrophysiologic, and Imaging Features

Short Title:
Subtypes of Post-Traumatic Epilepsy: Clinical, Electrophysiologic, and Imaging Features
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Journal Article
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Year, Volume, Issue, Page(s):
2014, vol. 1, issue , pp PubMed PMID 24693960
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Study identified and described the subtypes of post-traumatic epilepsy (PTE) that arise a consequence of traumatic brain injury (TBI). A retrospective chart review was performed of patients with moderate-to-severe TBI with subsequent development of medically refractory epilepsy referred for video-electroencephalography (EEG) monitoring at a single center over a 10-year period. Information regarding details of injury, neuroimaging studies, seizures, video-EEG, and surgery outcomes were collected and analyzed. There were 123 patients with PTE identified, representing 4.3 percent of all patients evaluated in the epilepsy monitoring unit. Most of them had localization-related epilepsy, of which 57 percent had temporal lobe epilepsy (TLE), 35 percent had frontal lobe epilepsy (FLE), and 3 percent each had parietal and occipital lobe epilepsy. Of patients with TLE, 44 percent had mesial temporal sclerosis (MTS), 26 percent had temporal neocortical lesions, and 30 percent were nonlesional. There was no difference in age at injury between the different PTE subtypes. Twenty-two patients, 13 of whom had MTS, proceeded to surgical resection. At a mean follow-up of 2.5 years, Engel Class I outcomes were seen in 69 percent of those with TLE and 33 percent of those with FLE. The findings suggest that PTE is a heterogeneous condition, and careful evaluation with video-EEG monitoring and high resolution magnetic resonance imaging can identify distinct syndromes. These results have implications for the design of clinical trials of antiepileptogenic therapies for PTE.
Gupta P, Ding K, Sayed N, Agostini M, Van Ness P, Madden C, Mickey B, D'Ambrosio R, Diaz-Arrastia R
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