Neurology: Traumatic brain injury increases the risk of late-onset epilepsy, especially repeated blows, severe injuries, and advanced age

Late-onset epilepsy (LOE, or epilepsy that begins in late adulthood) affects an increasing number of people worldwide
.
The annual incidence of first-time epilepsy in the elderly is higher than in any other period, ranging from 40-110/100,000 after the age of 60 and 175/100,000 after the age of 80

The Atherosclerosis Risk in Community (ARIC) study offers a unique opportunity
.
We assessed the association between head injury and LOE in a community-based older population using data collected over 30 years of follow-up and midlife

8872 participants were enrolled in the Atherosclerosis Risk in Community (ARIC) study, which included Centers for Continued Medicare Services (CMS) fee-for-service (FFS) coverage (55.

• The adjusted hazard ratio (HR) for LOE after a history of traumatic brain injury was 1.
  88 (95%CI=1.
  44-2.
  43)
  .
  
• There was evidence that a dose-response relationship with a greater risk of LOE was associated with an increase in prior head injury (HR = 1.
  37, 95% CI = 1.
  01- 1.
  88; for more than 2 head injuries, HR=3.
  55, 95%CI=2.
  51-5.
  02);
• More severe head injury compared with no head injury (HR = 2.
  53, 95% CI = 1.
  83-3.
  49 for mild injury; HR = 4.
  90, 95% CI = 3.
  15-7.
  64 for moderate/severe injury)
  .
  
• LOE was significantly associated with senile craniocerebral injury (age ≥ 67 years: HR=4.
  0 1, 95%CI=2.
  91-5.
  5 4), while it was significantly associated with younger craniocerebral injury (<67 years old: HR=0.
  98, 95%CI=0.
  6 8 ~1.
  4 1) Irrelevant
  .
  

      Head injuries are associated with an increased risk of developing LOE, especially when the head injury occurs at an older age, and there is evidence that after more prior and more severe head injuries, the Risk is higher
.

Source: Schneider ALC, Gottesman RF, Krauss GL, et al.