Predictors of new-onset seizures: a 10-year follow-up of head trauma subjects with and without traumatic brain injury

J Neurol Neurosurg Psychiatry. 2014 Jun;85(6):598-602. doi: 10.1136/jnnp-2012-304457. Epub 2013 Jun 12.

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.

Keywords: ALCOHOL-RELATED PROBLEMS.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Alcohol Drinking / adverse effects*
  • Brain Injuries / complications*
  • Brain Injuries / epidemiology
  • Brain Injuries / etiology
  • Child
  • Child, Preschool
  • Craniocerebral Trauma / complications*
  • Craniocerebral Trauma / diagnosis
  • Craniocerebral Trauma / epidemiology
  • Craniocerebral Trauma / etiology*
  • Female
  • Finland / epidemiology
  • Follow-Up Studies
  • Glasgow Coma Scale
  • Humans
  • Infant
  • Infant, Newborn
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Proportional Hazards Models
  • Registries
  • Risk Assessment
  • Risk Factors
  • Seizures / epidemiology*
  • Seizures / etiology*