Annegers J F, Coan S P
The University of Texas Health Science Center at Houston, School of Public Health, USA.
Seizure. 2000 Oct;9(7):453-7. doi: 10.1053/seiz.2000.0458.
The aim of this study is to present the incidence of traumatic brain injury (TBI) and identify those characteristics of brain injuries that are associated with the development of seizures. We identified 5984 episodes of TBI (loss of consciousness, post-traumatic amnesia, or skull fracture) in Olmsted County, Minnesota, from 1935 to 1984. Of these, 4541 were followed for seizure. Injuries were classified as mild (loss of consciousness or amnesia less than 30 minutes), moderate (loss of consciousness 30 minutes to 1 day or a skull fracture), or severe (loss of consciousness of more than 1 day, subdural hematoma, or brain contusion). The incidence of TBI in the period from 1975 to 84 peaked at 800 per 100 000 in males aged 15-24. The relative risk of seizures was 1.5 (95 percent confidence interval 1.0-2.2) after mild injuries, but with no increase after 5 years; 2.9 (95 percent confidence interval 1.9-4.1) after moderate injuries; and 17.2 (95 percent confidence interval 12.3-23.6) after severe injuries. Significant risk factors were brain contusion with subdural hematoma, skull fracture, loss of consciousness or amnesia of 1 day or more, and age over 65 years. We conclude that TBI is a major public health problem and contributes to the occurrence of seizures and epilepsy.
本研究的目的是呈现创伤性脑损伤（TBI）的发病率，并确定与癫痫发作发展相关的脑损伤特征。我们在明尼苏达州奥姆斯特德县确定了1935年至1984年期间5984例TBI发作（意识丧失、创伤后遗忘或颅骨骨折）。其中，4541例接受了癫痫发作随访。损伤被分类为轻度（意识丧失或遗忘少于30分钟）、中度（意识丧失30分钟至1天或颅骨骨折）或重度（意识丧失超过1天、硬膜下血肿或脑挫伤）。1975年至1984年期间，15至24岁男性的TBI发病率在每10万人中达到800例的峰值。轻度损伤后癫痫发作的相对风险为1.5（95%置信区间1.0 - 2.2），但5年后无增加；中度损伤后为2.9（95%置信区间1.9 - 4.1）；重度损伤后为17.2（95%置信区间12.3 - 23.6）。显著的风险因素包括伴有硬膜下血肿的脑挫伤、颅骨骨折、意识丧失或遗忘1天或更长时间以及65岁以上的年龄。我们得出结论，TBI是一个主要的公共卫生问题，并且会导致癫痫发作和癫痫的发生。
