Epilepsy Risk Higher in Soldiers with Brain Injuries

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The high numbers of soldiers who have suffered traumatic brain injuries associated with the wars in Iraq and Afghanistan face an array of health challenges, including post-traumatic stress disorder (PTSD) and other mental health issues. Now a new study highlights another finding: that these soldiers are at significantly high risk of developing epilepsy as much as a decade or more after their brain injury occurs.

Post-traumatic epilepsy is the most common cause of new cases of epilepsy in young adults, affecting approximately 30,000 people each year. According to the American Epilepsy Society, anyone who has suffered a brain injury is at risk for this type of epilepsy. Among individuals who experience moderate or severe injury, which includes bleeding into the brain or where brain tissue has died, the risk of traumatic brain epilepsy may be as great as 1 out of 2 people.

In the new study, the results of which were published in Neurology, researchers questioned 199 veterans who had experienced a brain injury 35 years ago about whether they had ever had a seizure. Nearly half—44 percent—of the veterans had developed post-traumatic epilepsy. Thirteen percent of the cases did not develop for more than 14 years after the brain injury had occurred.

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Jordan Grafman, PhD, of the National Institute of Neurological Disorders and Stroke and one of the study’s authors, noted that “Given the better chances of survival in soldier fighting in conflicts today, our research suggest that all veterans with a traumatic brain injury should be routinely screened for post-traumatic epilepsy, even decades after the injury.”

The American Epilepsy Society notes that seizures may first begin within days or weeks of a brain injury, but that often the time between the injury and the appearance of epilepsy is longer. Most epilepsy shows up within the first two years. The seizures are very easy to diagnose in some people, as they may suddenly lose consciousness, stiffen, fall, and display shaking of their arms and legs.

In other individuals, the seizures can be very subtle and difficult to identify. Sometimes people have memory problems, unexplained changes in behavior, emotional outbursts, or times when they stare into space. Because each of these symptoms can also be caused by other problems associated with traumatic brain injury or PTSD, the presence of epilepsy is not always identified.

Grafman points out that the new research “strongly suggests that veterans with brain injury will require long-term neurology care.” The investigators also found that the types of seizures soldiers experienced changed over time, often becoming more severe.

SOURCES:
American Academy of Neurology
American Epilepsy Society

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