| Nonconvulsive seizures after traumatic brain injury are associated with hippocampal atrophy. | |
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MedLine Citation:
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PMID: 20805525 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Neurology Volume: 75 ISSN: 1526-632X ISO Abbreviation: Neurology Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-08-31 Completed Date: 2010-09-28 Revised Date: 2011-09-13 |
Medline Journal Info:
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Nlm Unique ID: 0401060 Medline TA: Neurology Country: United States |
Other Details:
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Languages: eng Pagination: 792-8 Citation Subset: AIM; IM |
Affiliation:
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UCLA Department of Neurosurgery, Los Angeles, CA 90095, USA. Pvespa@mednet.ucla.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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:
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Neurology. 2010 Aug 31;75(9):760-1
[PMID:
20805520
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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