The VA is expecting a huge wave of posttraumatic epilepsy among its patients, according to Karen L. Parko, MD, Director of the Epilepsy Center at the San Francisco VA Medical Center, Chair of the National VA Epilepsy Centers of Excellence in San Francisco, and Associate Professor of Neurology at the University of California at San Francisco.
“There are guesses and estimates, because we now know there were 190,000 TBIs in service members since fiscal year 2000, but how many of those are going to eventually develop epilepsy we don’t know,” said Dr. Parko. “There’s a mathematical formula that’s used in the military to predict epilepsy from TBI, but no one thinks that formula is going to be applicable in this case, because the injuries are usually mild and the injury type is usually blast.” She added that while 50% of service members with penetrating missile TBI can be expected to develop epilepsy, only 12% of TBIs in service members fall into this category.
In 2008, Congress moved to prepare for the expected increase by mandating the establishment of the VA Epilepsy Centers of Excellence Network. At present, 15 VA Epilepsy Centers of Excellence have been geographically set up based on regional veteran populations. The centers have surgical capability and are grouped into four regions, each of which has its own polytrauma center.
“The network’s goal is to provide a high quality of care to veterans across the United States,” Dr. Parko said. “When you reintegrate into civilian life, no matter where you decide to live, you should be able to receive very high-level epilepsy care, up to and including surgery.”
—Jack Baney