Veterans who develop epilepsy after experiencing a traumatic brain injury (TBI) face a higher risk of death compared to those with epilepsy from other causes, according to new research from Baylor College of Medicine. The study, published in Neurology, analyzed health records from more than 210,000 veterans diagnosed with epilepsy. Of these, 28,832 had sustained a TBI within five years before their diagnosis.
Researchers found that veterans with post-traumatic epilepsy were 2% more likely to die than veterans with non-traumatic epilepsy. Dr. Zulfi Haneef, professor of neurology at Baylor and Center Director of the Epilepsy Center of Excellence at the Michael E. DeBakey VA Hospital, commented on the significance: “While the increase in risk may seem modest at first glance, it is substantial when you consider we are comparing against a population already at high risk of mortality. That makes this finding all the more concerning.”
The study also highlighted that younger veterans aged 18–39 with extracerebral injuries—those outside the brain but still impacting brain function—had twice the mortality rate compared to peers whose epilepsy was not trauma-related.
Risk levels differed based on injury type as well. Veterans who suffered skull or facial fractures had an 18% increased risk of death during the study period. Those with diffuse brain injuries affecting nerve fibers showed a 17% higher risk, while those with localized brain injuries faced a 16% higher risk.
“This is a particularly vulnerable group,” said Rohan Nagabhirava, primary author and second-year student at Baylor’s School of Medicine - Temple campus. “They may appear outwardly healthy, but the long-term consequences of traumatic brain injury can be serious, even fatal.”
One unexpected observation was that veterans who developed epilepsy following a concussion seemed to have lower mortality rates than other groups studied. However, researchers cautioned that this comparison was made within an already high-risk population.
Dr. Haneef emphasized ongoing care for affected individuals: “Overall, the findings underscore the need for early detection, aggressive treatment and ongoing monitoring for veterans with a history of TBI. If epilepsy is diagnosed, treatment should be prompt and tailored to each individual’s risk factors. Future studies are needed to increase our understanding and to draw more attention to this often-overlooked population.”
The research was supported by funding from the U.S. Department of Defense and relied on data from the Veterans Health Administration.
