Bytnar Julie A, Stahlman Shauna, Ying Saixia
MSMR. 2017 Dec;24(12):12-19.
Traumatic brain injury (TBI) is a known risk factor for seizures. Evidence also shows that post-traumatic stress disorder (PTSD) is associated with seizures, but the relationship in the absence of TBI remains unclear. This retrospective study spanning 2007-2016 separately quantifies the rates of seizures diagnosed among deployed and non-deployed active component military service members to understand the factors associated with seizures and whether they differ in deployed settings. Higher rates of seizures were associated with service members who were in the Army or Marine Corps; female; black; younger; lower enlisted; in a combat-specific, armor/motor transport, or healthcare occupation; and who had no more than one previous deployment. These associations were similar among both deployed and non-deployed service members. Either a TBI or recent PTSD diagnosis was associated with a 3- to 4-fold increased seizure rate. For service members who had received both diagnoses, seizure rates among the deployed and the non-deployed were two and three times the rates among those with only one of those diagnoses, respectively. If the current results are supported by future investigations, there may be implications for both clinical care and military policy.
创伤性脑损伤(TBI)是已知的癫痫发作风险因素。证据还表明,创伤后应激障碍(PTSD)与癫痫发作有关,但在无TBI的情况下二者的关系仍不明确。这项涵盖2007年至2016年的回顾性研究分别对已部署和未部署的现役军人中被诊断出癫痫发作的比率进行了量化,以了解与癫痫发作相关的因素以及这些因素在已部署环境中是否存在差异。癫痫发作率较高与陆军或海军陆战队军人、女性、黑人、较年轻、入伍级别较低、从事特定战斗、装甲/汽车运输或医疗保健职业以及此前部署次数不超过一次的军人有关。这些关联在已部署和未部署的军人中相似。TBI诊断或近期PTSD诊断均与癫痫发作率增加3至4倍有关。对于同时接受这两种诊断的军人,已部署和未部署军人的癫痫发作率分别是仅有一种诊断的军人的癫痫发作率的两倍和三倍。如果当前结果得到未来调查的支持,可能会对临床护理和军事政策产生影响。