Head injuries related to increased risk of late-onset epilepsy, says study

USA: A new study conducted by Andrea L.C. Schneider and team found that head injury is related to an increased incidence of late-onset epilepsy, which rises further with additional and more severe head traumas, which comes out as Class I evidence. The findings of this study were published in the journal Neurology on 22nd February 2022.

Late-onset epilepsy (LOE; epilepsy that begins in later adulthood) affects a large number of people. Although the head injury is a risk factor for acquired epilepsy, the extent to which earlier head damage may contribute to LOE is unknown. As a result, the goal of this study was to determine the relationship between head injury and the development of LOE.

This study comprised 8,872 people who were participating in the Atherosclerosis Risk in Communities (ARIC) study and had continuous Centers for Medicare and Medicaid Services fee-for-service (FFS) coverage (55.1% women, 21.6% Black). Researchers detected head injuries using connected Medicare fee-for-service payments for inpatient/emergency department care, active hospitalization surveillance, and participant self-report from 2014 to 2018. Through 2018, LOE instances were detected using connected Medicare FFS claims. In this investigation, Cox proportional hazards models were used to assess the correlations between head injury and LOE while controlling for cardiovascular, demographic, and lifestyle variables.

The results of this study stated as follow:

1. The adjusted hazard ratio (HR) for developing LOE following a history of head injury was 1.88.

2. There was evidence for dose-response associations with an increased risk of LOE with an increasing number of prior head injuries (HR 1.37 for 1 prior head injury and HR 3.55 for 2+ prior head injuries, compared to no head injuries) and severity of head injury (HR 2.53  for mild injury and HR 4.90 for moderate/s.

3. The associations with LOE were significant for head injuries received in later life (age 67 years: HR 4.01) but not for head injuries sustained in childhood.

In conclusion, head injury was linked to an increased chance of developing LOE, especially when experienced at an older age, and there was evidence indicating a higher risk of LOE after a high number of prior head injuries and after more severe head injuries.

Reference:

Schneider, A. L. C., Gottesman, R. F., Krauss, G. L., Gugger, J., Diaz-Arrastia, R., Kucharska-Newton, A., Huang, J., & Johnson, E. L. (2021). Association of Head Injury With Late-Onset Epilepsy. In Neurology (Vol. 98, Issue 8, pp. e808–e817). Ovid Technologies (Wolters Kluwer Health). https://doi.org/10.1212/wnl.0000000000013214