TABLE 7.1 Seizure Disorders and TBI

Reference

Study Design

Population

Type of TBI: Mild, Moderate, Severe; Blunt, Penetrating, Blast

Health Outcomes or Outcome Measures

Results

Adjustments

Comments or Limitations

Annegers et al., 1980

Retrospective cohort

2,747 patients of Olmsted County, MN, with head injuries sustained 1935–1974 compared with age-, sex-specific rates in general population; followed for 28,176 person-years Excluded deaths within 1 mo, seizures before TBI, prior epilepsy, second head injury, prior TBI, seizure within 1 week of TBI, febrile seizures 1,132 of 2,747 patients (41%) were children less than 15 years old

TBI determined by health-care provider, documented in medical record 195 severe head injuries: documented brain contusion (diagnosed by observation during surgery, or from focal neurologic abnormalities), intracranial hematoma, or at least 24 h of unconsciousness or PTA

Seizures determined from medical records

SIR; seizures in adults, children: < 1 year after trauma, SIR, 12.7 (95% CI, 7.7–20); 1–4 years after trauma, SIR, 4.4 (95% CI, 2.7–6.9); 5+ years after trauma, RR, 1.4 (95% CI, 0.7–2.5); overall SIR, 3.6 (95% CI, 2.7–4.8)

Age- and sex-matched controls

Children included in risk estimate; results include children, whose rates of seizures may be different from adults’ rates

 

 

912 moderate head injuries: skull fractures or head injuries, causing at least 0.5 h of unconsciousness or PTA 1,640 mild head injuries: no fracture but unconsciousness or PTA for less than 30 min

 

 

 

 

Annegers et al., 1998

Retrospective cohort

Same as above, but new cases added (4,541) for

Mild: LOC or amnesia for less than 30 min

Seizures determined from medical records

Including children, adults: Mild: SIR, 1.5 (95%

Cumulative probability of unprovoked

Children included in risk estimate; results include children,



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