Mortality rate higher in PTE than nontraumatic epilepsy; varies with underlying traumatic brain injury
By Elana Gotkine HealthDay Reporter
MONDAY, Nov. 3, 2025 (HealthDay News) — Veterans who develop epilepsy after traumatic brain injury (posttraumatic epilepsy [PTE]) have higher rates of mortality than those with nontraumatic epilepsy (NTE), according to a study published online Oct. 29 in Neurology.
Rohan Sri Nagabhirava, M.D., M.P.H., from the Baylor College of Medicine in Houston, and colleagues analyzed administrative data in the Veterans Health Administration to identify U.S. military veterans diagnosed with epilepsy from 2005 to 2022 to compare mortality between PTE and NTE. PTE was defined as traumatic brain injury documented in the five years prior to the index date of epilepsy.
Of the 210,182 veterans with epilepsy, 28,832 and 181,350 had PTE and NTE, respectively. The researchers found that the mortality rate was higher in PTE than NTE, and varied with underlying traumatic brain injury; the highest rates were seen with underlying diffuse cerebral injury, focal cerebral injury, and skull/facial fracture (hazard ratios, 1.17, 1.16, 1.18, respectively). The mortality rate was lower for underlying concussion than all NTE combined (hazard ratio, 0.91). There was variation in the relative mortality rate with age at onset of PTE, with the highest rate for young-onset PTE with extracerebral injury (hazard ratio, 2.02).
“While these findings need to be validated in future studies, we recommend that people who develop epilepsy after a traumatic brain injury are closely monitored, and, especially if seizures do not respond well to treatment, are prioritized for surgery or changing to new medications without delay,” coauthor Zulfi Haneef, M.D., M.B.B.S., also from the Baylor College of Medicine, said in a statement.
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