Abstract :

Background: Post-traumatic epilepsy is characterized by development of at least one seizure after the first week following a traumatic brain injury (TBI). In Ethiopia, there is a lack of data regarding the prevalence of post-traumatic epilepsy among epileptic patients.

Objective: This study aimed to assess the prevalence of post-traumatic epilepsy among epilepsy patients on follow-up at Tikur Anbessa Specialized Hospital (TASH) and Zewidtu Memorial Hospital (ZMH).

Methods and materials: An institution-based cross-sectional study design was implemented among patients with epilepsy attending the neurology clinic of TASH and ZMH. Data was collected from patients and medical records using a structured questionnaire and data abstraction format respectively. Descriptive analysis was conducted to summarize the socio-demographic and clinical characteristics of participants.

Results: In this study, 280 patients with epilepsy participated from Tikur Anbesa Specialized Hospital and Zewidtu Memorial Hospital with a response rate of 85%. Among participants, 21 (7.5%) were diagnosed with post-traumatic epilepsy. The mean age of these patients was 41.5 years, with a male-to-female ratio of 1.6:1. Road traffic accidents were the primary cause of brain trauma (61.9%) and subdural hematoma (19.04%) and intraparenchymal hemorrhage (19.04%) were the commonest imaging finding. In the majority of cases (91.5%), seizures began within a period of three years following a traumatic event. Generalized tonic-clonic seizures (57.1%) were the most common seizure type and generalized epileptiform discharges (35%) were the most common EEG finding.

Conclusions:  Post-traumatic epilepsy contributes significantly to the number of patients with epilepsy presenting to our neurology services, predominantly affecting the young active population, with road traffic accidents being the common mechanism.

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Keywords :

Generalized tonic-clonic seizures, Neurology clinic, Post-traumatic epilepsy, Road traffic accidents, Seizure prevalence, Traumatic brain injury.

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References :

1. Agrawal A, Timothy J, Pandit L, Manju M. Post-traumatic epilepsy: an overview. Clinical neurology and neurosurgery. 2006;108(5):433-9.
2. Frey LC. Epidemiology of Posttraumatic Epilepsy: A Critical Review. Epilepsia. 2003;44(s10):11-7.
3. Salazar AM, Jabbari B, Vance SC, Grafman J, Amin D, Dillon J. Epilepsy after penetrating head injury. I. Clinical correlates: a report of the Vietnam Head Injury Study. Neurology. 1985;35(10):1406-.
4. Almu S, Tadesse Z, Cooper P, Hackett R. The prevalence of epilepsy in the Zay Society, Ethiopia—An area of high prevalence. Seizure. 2006;15(3):211-3.
5. Bruns Jr J, Hauser WA. The epidemiology of traumatic brain injury: a review. Epilepsia. 2003;44:2-10.
6. Fisher RS, Acevedo C, Arzimanoglou A, Bogacz A, Cross JH, Elger CE, et al. ILAE official report: a practical clinical definition of epilepsy. Epilepsia. 2014;55(4):475-82.
7. World Health O. Epilepsy: a public health imperative: summary. Geneva: World Health Organization; 2019 2019. Contract No.: WHO/MSD/MER/19.2.
8. Lowenstein DH. Epilepsy after head injury: an overview. Epilepsia. 2009;50 Suppl 2:4-9.
9. Ferguson PL, Smith GM, Wannamaker BB, Thurman DJ, Pickelsimer EE, Selassie AW. A population‐based study of risk of epilepsy after hospitalization for traumatic brain injury. Epilepsia. 2010;51(5):891-8.
10. Haltiner AM, Temkin NR, Dikmen SS. Risk of seizure recurrence after the first late posttraumatic seizure. Archives of physical medicine and rehabilitation. 1997;78(8):835-40.
11. Tekle-Haimanot R, Forsgren L, Ekstedt J. Incidence of epilepsy in rural central Ethiopia. Epilepsia. 1997;38(5):541-6.
12. Perel P, Arango M, Clayton T, Edwards P, Komolafe E, Poccock S, et al. Predicting outcome after traumatic brain injury: practical prognostic models based on large cohort of international patients. Bmj. 2008;336(7641):425-9.
13. Roozenbeek B, Maas AI, Menon DK. Changing patterns in the epidemiology of traumatic brain injury. Nat Rev Neurol. 2013;9(4):231-6.
14. AAP. Diagnostic and statistical manual of mental disorders, fifth edition (DSM-5). Arlington, VA: American Psychiatric Association; 2013. 2013.
15. Motah M, Gams Massi D, Assonfack Sinju F, Magnerou AM, Bila Lamou EG, Nkouonlack C, et al. Post-traumatic epilepsy in Cameroon: a retrospective study in a referral hospital. The Egyptian Journal of Neurology, Psychiatry and Neurosurgery. 2023;59(1):1.
16. Ogunrin OA, Adeyekun AA. Profile of post-traumatic epilepsy in Benin City, Nigeria. West African journal of medicine. 2010;29(3):153-7.
17. Yachad N, Naidoo K. Pharmacological management of post-traumatic seizures in a South African paediatric intensive care unit. Southern African Journal of Critical Care. 2022;38(1):44-9.
18. Xu T, Yu X, Ou S, Liu X, Yuan J, Huang H, et al. Risk factors for posttraumatic epilepsy: A systematic review and meta-analysis. Epilepsy Behav. 2017;67:1-6.
19. Gupta RK, Saksena S, Agarwal A, Hasan KM, Husain M, Gupta V, et al. Diffusion tensor imaging in late posttraumatic epilepsy. Epilepsia. 2005;46(9):1465-71.
20. Gupta PK, Sayed N, Ding K, Agostini MA, Van Ness PC, Yablon S, et al. Subtypes of post-traumatic epilepsy: clinical, electrophysiological, and imaging features. J Neurotrauma. 2014;31(16):1439-43.
21. Hakimian S, Kershenovich A, Miller JW, Ojemann JG, Hebb AO, D’Ambrosio R, et al. Long-term outcome of extratemporal resection in posttraumatic epilepsy. Neurosurgical focus. 2012;32(3):E10.