Odds of Epilepsy with Moderate Traumatic Brain Injury Higher in Nondeployed Veterans

The risk of epilepsy in post-9/11 US veterans with moderate or severe traumatic brain injury (TBI) is higher in those who were not deployed compared with those who were deployed, according to study findings published online ahead of print in Neurology.

“This may be explained by the ‘healthy warrior effect,’ where good health is required for deployment,” said corresponding author Mary Jo V. Pugh, PhD, RN, of VA Salt Lake City, Salt Lake City, Utah. “We found those who had not been deployed had higher percentages of epilepsy risk factors, including brain tumors, stroke, and other neurologic diseases.”

The study included nearly 1 million post-9/11 veterans. Among them, 71% had a history of deployment, and 2.9% had epilepsy. By deployment status, the prevalence of epilepsy was 3.9% in veterans never deployed and 2.5% in veterans who were deployed.

Rates of TBI were 4% in nondeployed veterans and 34% in deployed veterans. For veterans with mild TBI, epilepsy risk did not differ with deployment status, according to the study.

The prevalence of moderate or severe TBI was 1.2% in nondeployed veterans and 2.5% in deployed veterans. Compared with veterans without TBI, nondeployed veterans were almost 3 times more likely, and deployed veterans were 2 times more likely, to have epilepsy after adjustment for age, sex, and other epilepsy risk factors, the study found.

Rates of penetrating TBI, the most severe TBI type, were 0.2% in nondeployed veterans and 0.5% in deployed veterans. Among veterans with penetrating TBI, those not deployed were 4 times, and those deployed were more than 5 times, more likely to have epilepsy compared with veterans without TBI.

“Closer monitoring for epilepsy among those with more risk factors for the disease may help shorten the time to diagnosis and appropriate treatment,” Dr Push advised.

References

Henion AK, Wang CP, Amuan M, et al. The role of deployment history on the association between epilepsy and traumatic brain injury in post-9/11 Era US Veterans. Neurology. Published online November 29, 2023. doi: 10.1212/WNL.0000000000207943

With some forms of TBI, non-deployed vets have higher risk of epilepsy than deployed. News release. American Academy of Neurology; November 29, 2023. Accessed December 6, 2023.