Epileptiform activity in traumatic brain injury predicts post‐traumatic epilepsy

We hypothesize that epileptiform abnormalities (EAs) in the electroencephalogram (EEG) during the acute period following traumatic brain injury (TBI) independently predict first‐year post‐traumatic epilepsy (PTE1). We analyze PTE1 risk factors in two cohorts matched for TBI severity and age (n = 50). EAs independently predict risk for PTE1 (odds ratio [OR], 3.16 [0.99, 11.68]); subdural hematoma is another independent risk factor (OR, 4.13 [1.18, 39.33]). Differences in EA rates are apparent within 5 days following TBI. Our results suggest that increased EA prevalence identifies patients at increased risk for PTE1, and that EAs acutely post‐TBI can identify patients most likely to benefit from antiepileptogenesis drug trials. Ann Neurol 2018;83:858–862