Risk factors for posttraumatic epilepsy: A systematic review and meta-analysis

Abstract Objective A systematic review and meta-analysis was performed to identify risk factors for posttraumatic epilepsy (PTE). Methods Two electronic databases (Medline and Embase) were searched to identify studies with a cohort, case-control, or cross-sectional design reporting on epidemiologic...

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Published in:Epilepsy & behavior 2017-02, Vol.67, p.1-6
Main Authors: Xu, Tao, Yu, Xinyuan, Ou, Shu, Liu, Xi, Yuan, Jinxian, Huang, Hao, Yang, Juan, He, Liang, Chen, Yangmei
Format: Article
Language:English
Subjects:
Adult
Alcoholism - complications
Alcoholism - diagnostic imaging
Brain Injuries, Traumatic - complications
Brain Injuries, Traumatic - diagnostic imaging
Case-Control Studies
Cohort Studies
Cross-Sectional Studies
Databases, Factual - trends
Epilepsy, Post-Traumatic - diagnostic imaging
Epilepsy, Post-Traumatic - etiology
Female
Humans
Male
meta-analysis
Neuroimaging - methods
Neuroimaging - trends
Neurology
posttraumatic epilepsy
Risk Factors
traumatic brain injury
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Summary:Abstract Objective A systematic review and meta-analysis was performed to identify risk factors for posttraumatic epilepsy (PTE). Methods Two electronic databases (Medline and Embase) were searched to identify studies with a cohort, case-control, or cross-sectional design reporting on epidemiologic evidence regarding risk factors for PTE. Results Men had a higher risk of developing PTE than women [relative ratio (RR), 1.32; 95% confidence interval (CI), 1.10–1.59]. A history of alcohol abuse (RR, 2.18; 95% CI, 1.26–3.79), posttraumatic amnesia (RR, 1.31; 95% CI, 1.12–1.53), focal neurologic signs (RR, 1.42; 95% CI, 1.16–1.74), and loss of consciousness at initial traumatic brain injury (TBI) (RR, 1.62; 95% CI, 1.13–2.32) were associated with a greater risk of PTE. TBI-related abnormal neuroimaging findings, including skull fracture (RR, 2.27; 95% CI, 1.49–3.44), midline shift (RR, 1.46; 95% CI, 1.14–1.87), brain contusion (RR, 2.35; 95% CI, 1.69–3.28), subdural hemorrhage (RR, 2.00; 95% CI, 1.33–3.01), and intracranial hemorrhage (RR, 2.65; 95% CI, 1.83–3.82) were strong risk factors for PTE. The risk of developing PTE after skull fracture, mild brain injury, and severe brain injury peaked within the first year after TBI, and then gradually decreased. However, a high risk of PTE was sustained for > 10 years. Conclusion The current meta-analysis identified potential risk factors for PTE. The results may contribute to better prevention strategies and treatments for PTE.
ISSN:1525-5050
1525-5069
DOI:10.1016/j.yebeh.2016.10.026