New study looks at prevalence of epilepsy in veterans with traumatic brain injury

The Journal of Head Trauma Rehabilitation
(Full article will be available until Aug. 31, 2014)

SAN ANTONIO (July 30, 2014) – By studying the medical records of veterans of the Afghanistan and Iraq wars who sustained traumatic brain injuries (TBIs), researchers at The University of Texas Health Science Center at San Antonio found those with mild TBIs — which are experienced by 85 percent of veterans with such injuries – were approximately 28 percent more likely of having epilepsy than individuals without TBIs.

Similar to prior studies, this research also showed that veterans who suffered penetrating or severe TBIs had the highest risk of developing epilepsy. However, this new study reveals the prevalence of epilepsy because of the high number of those who suffer mild TBIs.

Mary Jo Pugh, Ph.D., RN, associate professor in the Department of Epidemiology and Biostatistics in the School of Medicine at the UT Health Science Center, authored the study, “The Prevalence of Epilepsy and Association with Traumatic Brain Injury in Veterans of the Afghanistan and Iraq Wars,” which was recently published in the online version of The Journal of Head Trauma Rehabilitation.

“We saw that 24 percent of the veterans who had epilepsy also had experienced a TBI. That is compared to 11 percent of people without epilepsy,” said Dr. Pugh, a research health scientist with the South Texas Veterans Health Care System and a veteran of the U.S. Air Force. Funded by the VA Health Services Research and Development Administration, Dr. Pugh said the research was based on the records of 256,284 Afghanistan/Iraq veterans who received inpatient and outpatient care in the Veterans Health Administration in fiscal years 2009 and 2010.

This is an important group to study because 15 percent to 19 percent of the more than 2 million returning veterans have suffered a TBI with either loss of consciousness or altered mental status, she said.

“The high prevalence of TBIs has raised concerns for the long-term consequences of neurotrauma in this population. Based on data from previous wars, there is a particular concern for the risk of posttraumatic epilepsy,” Dr. Pugh said, adding that studies of veterans from World War II and the Korean War showed a link between combat-related head injury and epilepsy.

“This study shows us that we need to be prepared as a health care system,” she said. “Given the large number of individuals who have sustained deployment-related TBI, a substantial increased burden of epilepsy in this population is possible. The long-term consequences on the patient and the health care system includes increased risk of medical and social complications, including accidents, social stigmatization, loss of employment, inability to drive, and even death. These veterans should be followed closely, and systems of care, such as the VHA Epilepsy Centers of Excellence, should be prepared to provide epilepsy specialty care for these individuals.”

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The University of Texas Health Science Center at San Antonio, one of the country’s leading health sciences universities, ranks in the top 3 percent of all institutions worldwide receiving National Institutes of Health funding. The university’s schools of medicine, nursing, dentistry, health professions and graduate biomedical sciences have produced more than 29,000 graduates. The $765 million operating budget supports eight campuses in San Antonio, Laredo, Harlingen and Edinburg. For more information on the many ways “We make lives better®,” visit

South Texas Veterans Health Care System, (STVHCS) is comprised of two inpatient campuses: the Audie L. Murphy Campus in San Antonio and Kerrville Campus in Kerrville. The STVHCS serves one of the largest primary service areas in the nation and is part of the VA Heart of Texas Veterans Integrated Service Network (VISN 17), with offices located in Arlington. With an FY14 budget for STVHCS of $653 million and more than 3,400 employees, South Texas provides health care services for 81,000 unique veterans. In FY13, STVHCS provided almost 1,005,180 outpatient visits to area veterans.

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