Epilepsja pourazowa u ludności cywilnej: Charakterystyka kliniczna i społeczno-ekonomiczna

PURPOSE: Post-traumatic Epilepsy (PTE) has been reported to be more frequently drug-resistant and associated with higher rates of unemployment and dementia than other types of epilepsy, but previous studies are mainly from military or North American cohorts. We analyzed clinical and socioeconomic outcomes among individuals with PTE in a civilian European cohort. Age- and sex-matched persons with epilepsy of unknown etiology/cryptogenic epilepsy (EUE) were used as comparators. METHODS: In an observational study of epilepsy in Western Sweden (PREDICT, clinicaltrials.gov ID: NCT04559919), we included 27 individuals with PTE, with 3 age- and sex matched comparators per case with EUE. Epilepsy and socioeconomic data were collected from medical records and patient questionnaires with complementary data from national registers. Blood biomarkers of persistent brain injury were collected at inclusion. RESULTS: During the year prior to inclusion, 63% (95%CI:44-79%) of individuals with PTE reported seizure freedom. They had used an average of three anti-seizure medications (ASM), and 31% (95%CI:16-50%) used more than one ASM at inclusion. No significant differences were found in seizure frequency or severity compared to individuals with EUE. Brain injury markers were not elevated in the patients with PTE compared to EUE. Individuals with PTE were more frequently unemployed and less likely to hold a university degree. CONCLUSION: Seizure freedom and the proportion of patients on polytherapy were not different in patients with PTE compared to other types of epilepsy in our civilian cohort. Other outcomes than seizures may be needed for epilepsy care providers to identify PTE patients in need of psychosocial support.