title: Posttraumatic epilepsy: neuroradiologic and neuropsychological assessment of long-term outcome.
abstract: OBJECTIVE
  We sought to detect the incidence and the risk factors of posttraumatic epilepsy (PTE) in rehabilitation patients; to define the influence of PTE for late clinical and functional outcome; and to assess the cognitive and behavioral features of the patients with PTE.
  
  
  METHODS
  Patients were examined with (a) cognitive and behavioral examinations, which included a clinical interview and psychometric tests performed by an expert clinical psychologist; (b) single-photon emission computed tomography (SPECT) and magnetic resonance imaging (MRI); and (c) functional evaluation including the Glasgow Outcome Scale (GOS) and the Functional Independence Measure (FIM).
  
  
  RESULTS
  Of the 143 patients examined in this study, in 27 (19%), seizures developed after a mean time from trauma of 11.9 +/- 8.6 months. The occurrence of PTE was significantly correlated with the hypoperfusion in temporal lobes (p < 0.004), the degree of hydrocephalus (p < 0.04), the evidence of intracerebral hematoma (p < 0.01), and operative brain injury (p < 0.001). Patients with epilepsy showed a significantly higher incidence of personality disorders than did patients without epilepsy. The uninhibited behavior, irritability, and agitated and aggressive behavior were significantly more frequent and severe in PTE patients. The psychometric tests intended to explore memory, language, intelligence, attention, and spatial cognition did not show any significant difference between those with and without epilepsy. PTE also was significantly correlated with a worse functional outcome 1 year after the trauma.
  
  
  CONCLUSIONS
  The degrees of hydrocephalus and of hypoperfusion in the temporal lobes are significant risk factors for late PTE. Another main finding of our study is the absence of influence of epilepsy on cognitive disorders; its influence on neurobehavioral disorders and functional outcome is discussed.
authors.affiliation: Department of Neurology, San Giovanni Bosco Hospital, Torino, Italy. mazzini.1@libero.it
authors.forename: Letizia
authors.initials: L
authors.lastname: Mazzini
authors.forename: Federico Maria
authors.initials: FM
authors.lastname: Cossa
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Angelino
authors.forename: Riccardo
authors.initials: R
authors.lastname: Campini
authors.forename: Ilaria
authors.initials: I
authors.lastname: Pastore
authors.forename: Francesco
authors.initials: F
authors.lastname: Monaco
mesh_terms: D000203:Activities of Daily Living / Q000145:classification*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001925:Brain Damage, Chronic / Q000175:diagnosis / Q000534:rehabilitation; D002545:Brain Ischemia / Q000175:diagnosis / Q000534:rehabilitation; D002648:Child; D004834:Epilepsy, Post-Traumatic / Q000175:diagnosis* / Q000534:rehabilitation; D005260:Female; D005500:Follow-Up Studies; D023261:Glasgow Outcome Scale; D006801:Humans; D006849:Hydrocephalus / Q000175:diagnosis / Q000534:rehabilitation; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000534:rehabilitation; D008875:Middle Aged; D009483:Neuropsychological Tests; D012307:Risk Factors; D013702:Temporal Lobe / Q000098:blood supply; D015899:Tomography, Emission-Computed, Single-Photon