Epilepsy, a product of trauma in our time.

Using data obtained by the National Center for Health Statistics through household interviews, an estimate of 8,100,000 cases of head injury was determined for the civilian population of the United States in 1974. Excluding contusions and lacerations of the scalp, face, and neck; there remained 1,900,000 with concussion, skull fractures, intracranial hemorrhage, cerebral laceration, or other intracranial injury. Extrapolating from the military experience with craniocerebral trauma admittedly a rough approximation, it is estimated that in 30% of this latter group one more seizures will develop. Both severity of the injury and the predisposition of the injured are thought to play a part in the occurrence of seizures, with the predisposition playing the dominant role in the persistence of seizures. The following gradation of posttraumatic epilepsy is predicted for the 1,900,000 with the greater implication of brain damage: 1,340,000 will never have a seizure; 560,000 will develop one or more attacks, most of which will begin in 1974, 1975, or 1976. In 280,000 of these, the attacks will be transient and of little consequence. In an equal number, the attacks will require medical attention, and in some 140,000 the seizures will be intractable to therapy. This latter group represents 7% of the 1,900,000 cases. Attention is directed to the practical problems in the control of carniocerebral trauma and of posttraumatic epilepsy.