Predicting Epilepsy After Blunt Head Injury

Epilepsy occurs in rather less than 10% of patients admitted to hospital after a blunt head injury. The problem posed by a rather uncommon complication of a very common condition is to know which few patients, of the many at risk, are likely to develop it. If they could be recognized soon after injury, prophylactic anticonvulsants could be prescribed, different advice might be given about resettlement, and their lawyers could be advised to take the risk of epilepsy into account in assessing damages. The possibility of making a reliable prediction of epilepsy was explored by studying a series of head injuries prospectively and by investigating a number of patients with established traumatic epilepsy. The methods have been described in detail elsewhere with full statistical analysis (Jennett, 1962). The study was limited to non-missile head injuries admitted to hospital. While investigation of the influence of various factors on the incidence of epilepsy was based on a large series of cases from Oxford, Cardiff, and Manchester, estimation of the absolute overall incidence of epilepsy was based solely on 1,000 consecu tive admissions to the Accident Service of the Radcliffe Infirmary, Oxford. All patients with even brief amnesia after head injury were admitted to the service, which was the only one in the district. This series was therefore a relatively un selected one and included a high proportion of mild injuries compared with admissions to an average hospital ; the figure of 10% for the incidence of epilepsy is probably rather low on this account.