Risk of Epilepsy Following Traumatic Brain Injury: A Systematic Review and Meta-analysis

Abstract

Background: Limited evidence has explored the impact of traumatic brain injury (TBI) on posttraumatic epilepsy with control cohort for comparison. In addition, we could not find any review to identify the effect of TBI on the outcomes. Thus, we conducted this study to compare the risk of epilepsy between individuals with TBI and without TBI. Methods: Systematic and comprehensive search was carried out in the following databases and search engines: EMBASE, Cochrane, MEDLINE, ScienceDirect, and Google Scholar from 1954 until January 2022. The Newcastle Ottawa (NO) Scale was utilized to assess the risk of bias. Meta-analysis was carried out using the random-effects model, and pooled odds ratio (OR) along with 95% CI was reported. Results: In total, we included 10 studies satisfying inclusion criteria. Most studies had good to satisfactory quality. The pooled OR was 4.25 (95% CI, 1.77-10.25; I 2 = 100%), indicating that the individuals with TBI had 4.25 times higher risk of having epilepsy than individuals without TBI, and this association was statistically significant (P = .001). Subgroup analysis based on the years of follow-up revealed that the patients within 5 years post-TBI had the highest risk of epilepsy (pooled OR = 7.27; 95% CI, 3.61-14.64). Conclusion: Individuals with TBI had a significantly higher risk of epilepsy than the individuals without TBI, irrespective of the duration of the injury. Hence, long-term follow-up of the individuals with TBI is necessary to prevent any adverse consequences.