PREDICTORS AND DYNAMICS OF POSTTRAUMATIC EPILEPSY

Objectives - The goal of our study was to identify clinical, neurophys iological and neuroradiological variables in severe head trauma (SHT) with predictive value for posttraumatic epilepsy (PTE) and to evaluate the influence of each risk factor for the dynamics of epilepsy. Mater ial and methods - We systematically compared 57 PTE patients with 50 a ge and sex-matched control patients with SHT and no PTE. Mean follow-u p was a years. Results - Of all PTE-patients 68.5% had their first sei zure within 2 years after the trauma. Significant risk factors for PTE were focal signs in the first examination (P<0.01), missile injuries (P<0.01), frontal lesions (P<0.01), intracerebral hemorrhage (P<0.01), diffuse contusion (P<0.01), prolonged posttraumatic amnesia (P<0.001) , depression fracture (P<0.01) and cortical-subcortical lesions (P<0.0 01). The combination of the last 3 variables conferred a particularly high risk for PTE (logistic regression analysis). Combined seizure pat tern, high seizure frequency, AED-noncompliance and alcohol abuse pred icted poor seizure control. Conclusion The risk for PTE is clearly det ermined by those variables which correlate with the severity, the exte nt of tissue loss and the penetrating nature of the brain trauma.