Experts: Soldiers With Brain Injuries Could Develop Epilepsy

By Jamie Talan Newsday Thursday 29 March 2007

Epilepsy experts worry that veterans arriving home with traumatic brain injuries are at risk for seizures and these electrical storms could be subtle and develop months to several years following their initial injury.

"Epilepsy is very common following head injury," said Dr. Marc Dichter, professor of neurology and pharmacology at the University of Pennsylvania.

He was one of dozens of speakers at an epilepsy meeting held Thursday and continuing Friday at the National Institute of Neurological Disorders and Stroke in Bethesda, Md. "We are concerned that we will have a growing number of young people with head injuries who may develop epilepsy."

Right now, there are no treatments to prevent epilepsy, a condition that affects 1 to 2 percent of the population. Trauma and brain infection increase the risk for seizures.

"As the brain tries to repair itself, it may take time to ripen into seizures," said Dr. Dennis Spencer, an endowed professor of neurosurgery at Yale School of Medicine in Connecticut.

Government reports estimate more than 30,000 troops have been injured in the 4-year-old war in Iraq, and the two major wounds have been limb loss and traumatic brain injury. Veterans groups put the number of injured much higher.

Experts say it is hard to know exactly how many injured troops could later develop epilepsy. U.S. Army and other officials have said better medical care in Iraq has meant that more severely injured soldiers have been saved, only to return home with serious injuries, Dichter said. Severe brain trauma can trigger epilepsy in as many as 30 percent to 50 percent of the brain-injured soldiers, he added.

Early warning signs for epilepsy can include subtle changes in behavior, lapses in memory, strange sensory auras, attention problems and depression.

Most of the meeting was about new research in epilepsy. Researchers reported on a new material that can be laid over the brain that records information from thousands of neurons, which they said would enable them to better understand seizure activity.

John Donohue of Brown University is testing a way to detect seizures by placing into the brains of patients electrodes that can sense a seizure in the making.

Dichter is conducting a pilot study on head injuries, focusing on people who arrive at emergency rooms with gunshot wounds or wounds from accidents. These people are at greater risk of developing epilepsy over the next year or two. Funded by the Department of Defense, scientists also will test the effectiveness of short-term use of anti-seizure medicines to ward off seizures.

It took more than a year for 54-year-old Denise Pease of Corona, assistant comptroller for commercial banking in the Office of the New York City Comptroller, to get the right diagnosis and treatment for epilepsy.

"I went from being a vibrant woman with a bright future to being a candidate for an extended adult care facility," Pease told scientists at the meeting.

Months after a car accident 12 years ago she began losing her way on the street and forgetting familiar things. It wasn't until a relative witnessed a seizure that she received a proper diagnosis.

This week, the American Epilepsy Society also announced new efforts to help wounded soldiers on their return home. Post-traumatic stress disorder, common among soldiers, could also complicate diagnosis and treatment of epilepsy.