What are the risk factors for epilepsy following brain abscess?

  • In a population-based healthcare registry study of 1,179 people with brain abscess between 1982 and 2016 who survived for at least 30 days, 27% developed incident epilepsy after a median duration of 0.76 years.
  • Cumulative incidence rates of epilepsy were elevated in people with alcohol abuse (52% vs 31% in those without), aspiration or excision of brain abscess (41% vs 20%), stroke (46% vs 31%), and prior neurosurgery or head trauma (41% vs 31%). Analysis of adjusted mortality rate ratios (MRR) in a medical record review from 2007 to 2016 revealed seizures at admission for brain abscess (hazard rate ratio [HRR]= 3.70) and frontal lobe abscess (HRR=1.80) as additional risk factors for epilepsy.
  • Noting that epilepsy was associated with increased mortality risk (MRR=1.26), the study authors recommend that individual risk profiles could guide anti-epileptic therapy, and that specialized follow-up is required.