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Traumatic Brain Injury With and Without Late Posttraumatic Seizures: What Are the Impacts in the PostAcute Phase: A NIDRR Traumatic Brain Injury Model Systems Study

Bushnik, Tamara PhD; Englander, Jeffrey MD; Wright, Jerry MS, CBIST; Kolakowsky-Hayner, Stephanie A. PhD, CBIST

Journal of Head Trauma Rehabilitation: November/December 2012 - Volume 27 - Issue 6 - p E36–E44
doi: 10.1097/HTR.0b013e318273375c
Original Articles

Objective: To compare and contrast the levels of impairment, disability, and community participation of individuals with traumatic brain injury (TBI) with or without late posttraumatic seizures (LPTS).

Design: Prospective survey study.

Setting: Community.

Participants: Two groups of 91 individuals with TBI, with and without LPTS, were enrolled in the TBI Model Systems National Database between 1989 and 2002 and interviewed at years 1, 2, and 5 postinjury.

Interventions: Not applicable.

Main Outcome Measures: Demographic, injury severity, productivity, and psychosocial outcomes.

Results: The majority of the demographic and productivity outcomes up to 5 years postinjury were similar between individuals in the LPTS and non-LPTS groups. Both the LPTS and non-LPTS groups showed an increasing percentage of individuals who began to live alone after the first year postinjury and a decreasing percentage of individuals who were living with family members at 5 years postinjury compared with the first year post-TBI. A higher percentage of individuals in the LPTS group reported using more dependent forms of transportation such as riding with others or using public transportation. Individuals in the LPTS group had higher Disability Rating Scale scores at all time points, denoting greater functional disability, than individuals in the non-LPTS group, despite the 2 groups having similar Disability Rating Scale scores at discharge from rehabilitation. Satisfaction With Life Scale scores showed no changes over time but were significantly different between both groups at all time points, with individuals in the LPTS group reporting lower Satisfaction With Life Scale score than individuals in the non-LPTS group.

Conclusions: It does appear that the development of LPTS following a TBI is associated with poorer functional and psychosocial outcomes in the first 5 years after injury. It remains to be determined whether there are other factors that also may account for these differences and that may be amenable to intervention.

Rusk Institute for Rehabilitation Medicine, NYU Langone School of Medicine, New York (Dr Bushnik); and Santa Clara Valley Medical Center, Rehabilitation Research Center, San Jose, California (Drs Englander and Kolakowsky-Hayner and Mr Wright).

Corresponding Author: Tamara Bushnik, PhD, Rusk Institute for Rehabilitation Medicine, NYU Langone School of Medicine, 240 East 38th St, 17th Floor, New York, NY 10016 (tamara.bushnik@nyumc.org).

This study was funded by grants (H133A070038) from the National Institute on Disability and Rehabilitation Research.

The authors declare no conflicts of interest.

© 2012 Lippincott Williams & Wilkins, Inc.