Intractable epilepsy and mild brain injury: incidence, pathology and surgical outcome

Bahman Jabbari Department of Neurology and Neurosurgery Service, Walter Reed Army Medical Center, Washington, DC, USA Uniformed Services University, Bethesda, MD, USA Department of Neuropathology, Armed Forces Institute of Pathology, Washington, DC, USA

Olga Prokhorenko Department of Neurology and Neurosurgery Service, Walter Reed Army Medical Center, Washington, DC, USA Uniformed Services University, Bethesda, MD, USA Department of Neuropathology, Armed Forces Institute of Pathology, Washington, DC, USA

Kaveh Khajavi Department of Neurology and Neurosurgery Service, Walter Reed Army Medical Center, Washington, DC, USA Uniformed Services University, Bethesda, MD, USA Department of Neuropathology, Armed Forces Institute of Pathology, Washington, DC, USA

Hernando Mena Department of Neurology and Neurosurgery Service, Walter Reed Army Medical Center, Washington, DC, USA Uniformed Services University, Bethesda, MD, USA Department of Neuropathology, Armed Forces Institute of Pathology, Washington, DC, USA

Abstract

Objective : To study the role of mild brain injury in intractable epilepsy. Methods : The medical charts of 86 patients who underwent surgery for intractable epilepsy were reviewed in regard to the history of mild brain injury, pathology and surgical outcome. Results : Nine of 86 patients had a previous history of mild brain injury (10.4%) compared to 2.5% of 80 age and sex matched controls. Six of nine patients had non-neoplastic and three had neoplastic lesions. Post-surgical outcome was excellent in eight of nine patients (Engel class IA). Conclusions : The incidence of mild brain injury was 4-times higher in patients with intractable epilepsy compared to asymptomatic controls. The pathology was variable but in four of nine patients it was compatible with the described pathology in traumatic brain injury. Both groups, with or without brain injury, had good surgical outcome (88% versus 70%).

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Intractable epilepsy and mild brain injury: incidence, pathology and surgical outcome

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Intractable epilepsy and mild brain injury: incidence, pathology and surgical outcome

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