Correlates of posttraumatic epilepsy 35 years following combat brain injury

Raymont, Vanessa; Salazar, Andrés M.; Lipsky, Robert H.; Goldman, David; Tasick, G.; Grafman, Jordan

doi:10.1212/wnl.0b013e3181e8e6d0

Cited by 161 publications

(126 citation statements)

References 35 publications

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“…One implication of these findings is that the rate of ictal activation might be useful as a gauge of seizure probability. Severity of brain injury correlates with the incidence and severity of the subsequent epilepsy (Ferguson et al, 2010;Raymont et al, 2010). The current data support the idea that these correlations may arise from loss of afferent and efferent connections and the consequent degree of recurrent connectivity in the epileptic focus.…”

Section: Clinical Implications Activation Of Epileptic Networksupporting

confidence: 78%

“…Post-traumatic epilepsy is increasingly being recognized as an important public health problem (Ferguson et al, 2010;Raymont et al, 2010). We know very little about the processes that underlie the development of epilepsy after brain injury (Lowenstein, 2009;Noebels et al, 2012;Pitkänen and Immonen, 2014), and thus cannot develop rational treatments for this particularly refractory form of secondary epilepsy (Temkin, 2009;Prince et al, 2012;Goldberg and Coulter, 2013).…”

Section: Introductionmentioning

confidence: 99%

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Evolution of Network Synchronization during Early Epileptogenesis Parallels Synaptic Circuit Alterations

Lillis

Wang

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et al. 2015

Journal of Neuroscience

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In secondary epilepsy, a seizure-prone neural network evolves during the latent period between brain injury and the onset of spontaneous seizures. The nature of the evolution is largely unknown, and even its completeness at the onset of seizures has recently been challenged by measures of gradually decreasing intervals between subsequent seizures. Sequential calcium imaging of neuronal activity, in the pyramidal cell layer of mouse hippocampal in vitro preparations, during early post-traumatic epileptogenesis demonstrated rapid increases in the fraction of neurons that participate in interictal activity. This was followed by more gradual increases in the rate at which individual neurons join each developing seizure, the pairwise correlation of neuronal activities as a function of the distance separating the pair, and network-wide measures of functional connectivity. These data support the continued evolution of synaptic connectivity in epileptic networks beyond the latent period: early seizures occur when recurrent excitatory pathways are largely polysynaptic, while ongoing synaptic remodeling after the onset of epilepsy enhances intranetwork connectivity as well as the onset and spread of seizure activity.

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Section: Clinical Implications Activation Of Epileptic Networksupporting

confidence: 78%

Section: Introductionmentioning

confidence: 99%

Evolution of Network Synchronization during Early Epileptogenesis Parallels Synaptic Circuit Alterations

Lillis

Wang

Mail

et al. 2015

Journal of Neuroscience

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“…Gorin wrote on a few postictal symptoms in PTE, of which we found 11% of these symptoms in our results [14]. We found that the time from brain injury to PTE for the majority of patients (51%) was 1 year, which was similar to the value published by Frey (86%, 2 years) and Raymond (57.6%, 1 year) [5,15].…”

Section: Discussionsupporting

confidence: 89%

Untitled

2015

Cent Asian J Med Sci

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Objectives:To study the manifestations of the paroxysms, the variants of the course, and to determine the significant predictive factors for post-traumatic epilepsy (PTE) in Ulaanbaatar, Mongolia. methods: We obtained the histories of 109 PTE patients who came to district health associations and the Central First Clinic in Ulaanbaatar from 2011 to 2013. We conducted a questionnaire and performed clinical examination to evaluate seizures in accordance with semiologic and international classification of epileptic seizures. Clinical data was matched with the results of electroencephalography (EEG), computed tomography (CT), and magnetic resonance imaging (MRI). Results: Of the 109 patients, 93 (85%) presented with secondary generalized partial seizure (SGPS), 16 (15%) with partial seizure and 66 (60.5%) with motor phenomena. The seizure frequency was not correlated with the structural brain abnormalities, but there was an inverse association (r=-0.32, p<0.001) between seizure frequency and the duration of PTE. PTE was positively correlated with severe injury, contusion, early onset of seizures (p<0.05), and operative brain injury (p<0.005). conclusion: Clinical features of PTE were presented as secondary generalized seizure and motor phenomena in the majority of patients. PTE was characterized commonly by long durations of high seizure frequency and significantly affected by factors such as severity of head injury and operative brain injury.

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“…Veterans are at a higher risk of developing seizures than the general public, in part due to the increased rate of traumatic brain injuries (TBIs) experienced during combat and while in service [1][2][3][4][5]. In response to concerns of increased posttraumatic epilepsy among returning servicemembers from current conflicts, the U.S. Congress passed the Veterans' Mental Health and Other Care Improvements Act of 2008, mandating the establishment of the Veterans Health Administration (VHA) Epilepsy Centers of Excellence (ECoE).…”

Section: Introductionmentioning

confidence: 99%

Characteristics of Veterans diagnosed with seizures within Veterans Health Administration

et al. 2015

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Abstract-The purpose of this report is to describe the demographics of Veterans diagnosed with seizures and taking antiepileptic drugs (AEDs) within the Veterans Health Administration (VHA) during fiscal year (FY) 2011 (October 1, 2010, to September 30, 2011, particularly with regard to comorbid traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD). Information collected included age; sex; Operation Iraqi Freedom/Operation Enduring Freedom/Operation New Dawn (OIF/OEF/OND) status; and relevant encounter diagnosis codes for seizures, TBI, and PTSD. During FY11, 87,377 Veterans with seizures on AEDs were managed within the VHA. Prevalence was 15.5 per 1,000, and annual incidence was 148.2 per 100,000. The percentages of comorbid TBI and PTSD were 15.8% and 24.1%, respectively. For OIF/OEF/ OND Veterans, these percentages increased to 52.6% and 70.4%, respectively. PTSD and TBI are risk factors for both epilepsy and psychogenic nonepileptic seizures. Within the VHA, many Veterans experiencing seizures cannot be successfully treated with AEDs. The VHA Epilepsy Centers of Excellence promotes a multidisciplinary approach to increase and improve access to both epilepsy and mental health specialists for the care of epileptic and nonepileptic seizures.

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Correlates of posttraumatic epilepsy 35 years following combat brain injury

Abstract: Background:The Vietnam Head Injury Study (VHIS) is a prospective, longitudinal follow-up of

Cited by 161 publications

References 35 publications

Evolution of Network Synchronization during Early Epileptogenesis Parallels Synaptic Circuit Alterations

Evolution of Network Synchronization during Early Epileptogenesis Parallels Synaptic Circuit Alterations

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Characteristics of Veterans diagnosed with seizures within Veterans Health Administration

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