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Mild traumatic brain injury and epilepsy: alcohol misuse may underpin the association
  1. Killian A Welch1,
  2. Christopher Derry2
  1. 1Robert Fergusson Unit, Department of Neurological Rehabilitation, Royal Edinburgh Hospital, Edinburgh, UK
  2. 2Department of Clinical Neurosciences, Western General Hospital, Edinburgh, UK
  1. Correspondence to Dr Killian A Welch, Robert Fergusson Unit, Department of Neurological Rehabilitation, Royal Edinburgh Hospital, Edinburgh EH10 5HF, UK; kwelch1{at}staffmail.ed.ac.uk

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Mild traumatic brain injury (mTBI) is associated with various neurological and cognitive problems, but causality is often less clear. For example, postconcussion syndrome (PCS) was widely assumed to be a consequence of neural damage until it was demonstrated that: (1) the symptoms of PCS are not specific to brain injury, being common in the general population,1 (2) ‘PCS’ is as common in those who experience physical trauma without brain injury as those who experience mTBI,2 (3) preinjury factors, such as a history of anxiety or affective disorder, predict development of PCS,2 (4) PCS has a strong relationship with PTSD-type symptoms3 and (5) lower cognitive function may be a risk factor for mTBI rather than a consequence of it.4

Vaaramo et al5 underline the problems inherent in assuming causation on the basis of association in head …

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