Predictors of new-onset seizures: a 10-year follow-up of head trauma subjects with and without traumatic brain injury
- 1Department of Neurology, Oulu University Hospital, Oulu, Finland
- 2Department of Neurosurgery, Oulu University Hospital, Oulu, Finland
- 3Department of Clinical Neurosciences, University of Helsinki, Helsinki, Finland
- Correspondence to Dr Sami Tetri, Department of Neurosurgery, Oulu University Hospital, Kajaanintie 52, Oulu 90029, Finland;
- Received 30 October 2012
- Revised 3 May 2013
- Accepted 13 May 2013
- Published Online First 12 June 2013
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.