Predictors of new-onset seizures: a 10-year follow-up of head trauma subjects with and without traumatic brain injury. Issue 6 (12th June 2013)

• Record Type: Journal Article
• Authors: Vaaramo, Kalle; Puljula, Jussi; Tetri, Sami; Juvela, Seppo; Hillbom, Matti
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 85:Issue 6(2014)
• Page Start: 598
• Page End: 602
• Publication Date: 2013-06-12
• Subjects: ALCOHOL-RELATED PROBLEMS; Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp-2012-304457
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Background: It is not known whether alcohol-related head trauma predicts the new-onset seizures, particularly alcohol-related seizures. Objective: We investigated risk factors for new-onset seizures in a cohort of 739 head trauma subjects. Methods: All subjects with head trauma attending Oulu University Hospital during 1999, including children and very old people but excluding persons with previous seizures and/or neurological diseases, were enrolled and followed up until the end of 2009. The Finnish National Hospital Discharge Register was used to identify all visits due to seizures during the 10-year follow-up. Dates of death were obtained from the official Cause-of-Death Statistics. Cox proportional hazard regression models and Kaplan-Meier survival curves were used to identify predictors of new-onset seizures. Results: New-onset seizures were observed in 42 out of the 739 subjects (5.7%). An alcohol-related index injury (adjusted HR 2.50, 95% CI 1.30 to 4.82, p=0.006), moderate-to-severe traumatic brain injury (TBI) as the index trauma (3.13, 1.46 to 6.71, p=0.003) and preceding psychiatric disease (3.23, 1.23 to 9.21, p=0.028) were significant predictors of new-onset seizures during the follow-up after adjustment for age and sex. An alcohol-related index injury was the only independent predictor of the occurrence of an alcohol-related new-onset seizure (adjusted HR 12.13, 95% CI 2.70 to 54.50, p=0.001), and these seizures (n=19) developed more frequently among subjects without (n=14) than with (n=5) TBI. Conclusions: We conclude that alcohol-related head trauma predicts new-onset seizures, particularly alcohol-related seizures. A brief intervention is needed in order to prevent the development of alcohol-related seizures.