• Yilun Chen, Songlu Li, Wendong Ge, Jin Jing, Hsin Yi Chen, Daniel Doherty, Alison Herman, Safa Kaleem, Kan Ding, Gamaleldin Osman, Christa B Swisher, Christine Smith, Carolina B Maciel, Ayham Alkhachroum, Jong Woo Lee, Monica B Dhakar, Emily J Gilmore, Adithya Sivaraju, Lawrence J Hirsch, Sacit B Omay, Hal Blumenfeld, Kevin N Sheth, Aaron F Struck, Brian L Edlow, M Brandon Westover, and Jennifer A Kim.
• Neurology, Yale School of Medicine, New Haven, Connecticut, USA.
• J. Neurol. Neurosurg. Psychiatr. 2023 Mar 1; 94 (3): 245249245-249.

BackgroundPost-traumatic epilepsy (PTE) is a severe complication of traumatic brain injury (TBI). Electroencephalography aids early post-traumatic seizure diagnosis, but its optimal utility for PTE prediction remains unknown. We aim to evaluate the contribution of quantitative electroencephalograms to predict first-year PTE (PTE1).MethodsWe performed a multicentre, retrospective case-control study of patients with TBI. 63 PTE1 patients were matched with 63 non-PTE1 patients by admission Glasgow Coma Scale score, age and sex. We evaluated the association of quantitative electroencephalography features with PTE1 using logistic regressions and examined their predictive value relative to TBI mechanism and CT abnormalities.ResultsIn the matched cohort (n=126), greater epileptiform burden, suppression burden and beta variability were associated with 4.6 times higher PTE1 risk based on multivariable logistic regression analysis (area under the receiver operating characteristic curve, AUC (95% CI) 0.69 (0.60 to 0.78)). Among 116 (92%) patients with available CT reports, adding quantitative electroencephalography features to a combined mechanism and CT model improved performance (AUC (95% CI), 0.71 (0.61 to 0.80) vs 0.61 (0.51 to 0.72)).ConclusionsEpileptiform and spectral characteristics enhance covariates identified on TBI admission and CT abnormalities in PTE1 prediction. Future trials should incorporate quantitative electroencephalography features to validate this enhancement of PTE risk stratification models.© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.

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