Document Detail


Nonconvulsive seizures after traumatic brain injury are associated with hippocampal atrophy.
MedLine Citation:
PMID:  20805525     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine if posttraumatic nonconvulsive electrographic seizures result in long-term brain atrophy.
METHODS: Prospective continuous EEG (cEEG) monitoring was done in 140 patients with moderate to severe traumatic brain injury (TBI) and in-depth study of 16 selected patients was done using serial volumetric MRI acutely and at 6 months after TBI. Fluorodeoxyglucose PET was done in the acute stage in 14/16 patients. These data were retrospectively analyzed after collection of data for 7 years.
RESULTS: cEEG detected seizures in 32/140 (23%) of the entire cohort. In the selected imaging subgroup, 6 patients with seizures were compared with a cohort of 10 age- and GCS-matched patients with TBI without seizures. In this subgroup, the seizures were repetitive and constituted status epilepticus in 4/6 patients. Patients with seizures had greater hippocampal atrophy as compared to those without seizures (21 +/- 9 vs 12 +/- 6%, p = 0.017). Hippocampi ipsilateral to the electrographic seizure focus demonstrated a greater degree of volumetric atrophy as compared with nonseizure hippocampi (28 +/- 5 vs 13 +/- 9%, p = 0.007). A single patient had an ictal PET scan which demonstrated increased hippocampal glucose uptake.
CONCLUSION: Acute posttraumatic nonconvulsive seizures occur frequently after TBI and, in a selected subgroup, appear to be associated with disproportionate long-term hippocampal atrophy. These data suggest anatomic damage is potentially elicited by nonconvulsive seizures in the acute postinjury setting.
Authors:
P M Vespa; D L McArthur; Y Xu; M Eliseo; M Etchepare; I Dinov; J Alger; T P Glenn; D Hovda
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Neurology     Volume:  75     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-31     Completed Date:  2010-09-28     Revised Date:  2013-05-28    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  792-8     Citation Subset:  AIM; IM    
Affiliation:
UCLA Department of Neurosurgery, Los Angeles, CA 90095, USA. Pvespa@mednet.ucla.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Atrophy
Brain Injuries / complications,  pathology*,  physiopathology
Cohort Studies
Electroencephalography / trends
Epilepsy, Generalized / etiology,  pathology*,  physiopathology
Female
Follow-Up Studies
Hippocampus / pathology*,  physiopathology
Humans
Male
Middle Aged
Prospective Studies
Seizures / etiology,  pathology*,  physiopathology
Grant Support
ID/Acronym/Agency:
1 P01 NS058489-01/NS/NINDS NIH HHS; 1 R01 NS052406/NS/NINDS NIH HHS; 1 R01 NS055910-01A1/NS/NINDS NIH HHS; 1 R01NS27544/NS/NINDS NIH HHS; 1 R21 NS057252-01A1/NS/NINDS NIH HHS; 1R21NS057252-01A1/NS/NINDS NIH HHS; NS 02089/NS/NINDS NIH HHS; NS 049471/NS/NINDS NIH HHS; P50 HL60296/HL/NHLBI NIH HHS; P50 NS044378/NS/NINDS NIH HHS; R01 EB00822/EB/NIBIB NIH HHS; R01 EY15311/EY/NEI NIH HHS; R01 NR009116/NR/NINR NIH HHS; R01 NS 049471/NS/NINDS NIH HHS; R01 NS036524/NS/NINDS NIH HHS; R01 NS049471/NS/NINDS NIH HHS; R01 NS051591/RG3915/NS/NINDS NIH HHS; R01MH081864/MH/NIMH NIH HHS; R01NS 49471/NS/NINDS NIH HHS; R01NS46018/NS/NINDS NIH HHS; R21 MH075658/MH/NIMH NIH HHS
Comments/Corrections
Comment In:
Neurology. 2010 Aug 31;75(9):760-1   [PMID:  20805520 ]

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