Singer R B
J Insur Med. 2001;33(1):42-5.
Records of the Rochester Epidemiological Project were used to determine the incidence of secondary seizures after traumatic brain injury (TBI) in all cases treated for this condition in the population of Olmsted County, Minn, from 1935 to 1984. Medical records of the Mayo Clinic and all other medical facilities in Olmsted County, Minn, are in the database of this Project. Incidence rates after TBI were compared with incidence rates of idiopathic epilepsy previously determined for Olmsted County.
TBI cases were divided into 3 defined severity categories: mild, moderate, and severe. Out of 4541 cases of TBI accumulated in 50 years only 97 cases developed 1 or more seizures (46 cases of seizure secondary to other definite causes were excluded). Incidence rates were highest in the first year after the head injury. The overall excess incidence rate was very low in mild TBI, only 0.3 per 1000 per year, but was higher in severe TBI, with an excess rate of 10 per 1000 per year. Only 7.2% of the TBI cases were classified as severe (loss of consciousness or amnesia for more than 24 hours, subdural hematoma, or brain contusion).
The long-term incidence of seizures beyond the incidence rate of idiopathic epilepsy is low after mild or moderate TBI, but is at the rate of 10 excess cases per 1000 per year in the minority of cases with severe TBI.
利用罗切斯特流行病学项目的记录，确定了1935年至1984年明尼苏达州奥尔姆斯特德县接受治疗的所有创伤性脑损伤（TBI）病例中继发性癫痫发作的发生率。梅奥诊所及明尼苏达州奥尔姆斯特德县所有其他医疗机构的病历均收录于该项目数据库中。将TBI后的发病率与先前确定的奥尔姆斯特德县特发性癫痫发病率进行了比较。
TBI病例分为3个明确的严重程度类别：轻度、中度和重度。50年间累积的4541例TBI病例中，只有97例出现1次或更多次癫痫发作（排除46例继发于其他明确病因的癫痫发作病例）。发病率在头部受伤后的第一年最高。轻度TBI的总体超额发病率非常低，仅为每年每1000人中有0.3例，但重度TBI的超额发病率较高，为每年每1000人中有10例。只有7.2%的TBI病例被归类为重度（意识丧失或失忆超过24小时、硬膜下血肿或脑挫伤）。
轻度或中度TBI后，癫痫发作的长期发病率超过特发性癫痫发病率的情况较低，但在少数重度TBI病例中，发病率为每年每1000人中有10例超额病例。
