Connecting the dots

Veterans of the Afghanistan and Iraq wars who sustained mild traumatic brain injuries (TBIs) were 28 percent more likely to have epilepsy than those with without TBIs, Health Science Center researchers found.

They studied the medical records of veterans from both wars who sustained traumatic brain injuries. Similar to prior studies, this research also showed that veterans who suffered penetrating or severe TBIs had the highest risk of developing epilepsy.

“We saw that 24 percent of the veterans who had epilepsy also had experienced a TBI. That is compared to 11 percent of people without epilepsy,” said Mary Jo Pugh, Ph.D., RN, associate professor in the Department of Epidemiology and Biostatistics who is also a research health scientist with the South Texas Veterans Health Care System and a veteran of the U.S. Air Force.

Funded by the VA Health Services Research and Development Administration, the research was based on the records of 256,284 Afghanistan and Iraq veterans who received inpatient and outpatient care in the Veterans Health Administration (VHA) in fiscal years 2009 and 2010.

Of the more than 2 million returning veterans, 15 to 19 percent of them have suffered a TBI with either loss of consciousness or altered mental state.

“The high prevalence of TBIs has raised concerns for the long-term consequences of neurotrauma in this population. Based on data from previous wars, there is a particular concern for the risk of post-traumatic epilepsy,” Dr. Pugh said, adding that studies of veterans from World War II and the Korean War showed a link between combat-related head injury and epilepsy.

“This study shows us that we need to be prepared as a health care system,” she said. “Given the large number of individuals who have sustained deployment-related TBIs, a substantial increased burden of epilepsy in this population is possible. The long-term consequences on the patient and the health care system includes increased risk of medical and social complications, including accidents, social stigmatization, loss of employment, inability to drive and even death. These veterans should be followed closely, and systems of care, such as the VHA Epilepsy Centers of Excellence, should be prepared to provide epilepsy specialty care for these individuals.”