Prevalence of epilepsy and seizure history in Finnish neuropathologically examined medico-legal autopsy cases with acute head injuries

Abstract Objectives Epilepsy and traumatic brain injury have a bidirectional relationship. This study aimed to report the prevalences of antemortem epilepsy diagnosis, seizure history, epilepsy-related and traumatic neuropathological findings, as well as background characteristics, among neuropathologically examined medico-legal autopsy cases with acute head injuries. Results The sample included 82 cases from Helsinki, Finland, from the years 2016—2022. Of the sample, 17 cases had an epilepsy diagnosis or documented seizure history (“Epilepsy/Seizure Group”), whereas 65 did not (“No Seizure Group”). The most frequent epilepsy-related neuropathological findings were hippocampal atrophy and mossy fibre sprouting. Of background characteristics, the Epilepsy/Seizure Group had a higher prevalence of old head injuries (41.2% vs. 7.7%) and chronic alcohol use (41.2% vs. 18.5%) than the No Seizure Group. There were no statistically significant differences in acute head injuries or secondary neuropathological findings, except for a lower prevalence of oedema in the Epilepsy/Seizure Group (17.6% vs. 47.7%). Even though the Epilepsy/Seizure Group had a higher prevalence of old head injuries and chronic alcohol use, the prevalences of acute head injuries were not higher. Larger studies are needed to further explore whether individuals with epilepsy or seizure history are susceptible to distinct head injury types or circumstances.