Post-Traumatic Epilepsy: Observations from an Urban Level 1 Trauma Center

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

This study investigates the prevalence and long-term follow-up of post-traumatic epilepsy (PTE) in patients with traumatic brain injury (TBI) at an urban Level 1 Trauma Center. The study identifies significant risk factors for developing PTE, such as severe TBI, and highlights the need for better follow-up care for these patients. The topic is interesting, and the manuscript is well written. In my opinion, only few concerns need to be addressed:

 

• Although TBI and PTE are explained in the abstract, they should also be explained in the main text.
• Although it is stated in the materials and methods section that “continuous variables were compared using a 2-sample student’s t-test and categorical variables were compared using Pearson chi-square test. Univariate logistic regression model was used to identify factors associated with PTE and if significant, these variables were then tested in a multivariable analysis model.” in my opinion, in the Results section it should be highlighted which test is used for each comparison performed.
• Similarly, in the caption of the tables, it should be stated which test was performed to obtain the results. The Authors could consider inserting the tables where they are mentioned rather than to provide a separate section.
• In the Discussion section, the Authors should stress the importance of the findings, the impact on clinical practice and research, and propose some future research.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

In this article, the authors sought to explore the relationship between TBI and post-traumatic epilepsy (PTE) through clinical data obtained from the Temple University Hospital database. The authors presented very interesting data in this field that will be useful in future studies. The study is scientifically sound and adequately written. However, several minor issues should be addressed.

1) In the "Introduction" section, the authors stated that 66% of patients with moderate TBI would develop PTE, which is also a significant percentage of comorbidity. These statistics suggest that moderate injuries should also be examined as a possible variable for PTE, yet the authors didn't say anything about this level of injury in the article. How many patients had moderate TBI out of the full cohort?

2) The results section is extremely short, and many of the tables are not sufficiently described. 

3) What form of injury did the authors include in this study? The authors noted that 104 patients had penetrating injuries, so I would assume both contusion and others were included. Did the authors include blast injuries? 

4) The authors noted the percentage of patients with stroke. What kind of stroke? Ischemic, hemorrhagic? Was it caused by TBI? Did the patients already have cerebrovascular problems prior to the injury? 

5) The authors noted that 9.3% of the patients had depression. What is the connection between depression and PTE? Was the depression diagnosed after the TBI or prior to the injury? 

6) The authors noted the percentage of patients with alcohol abuse. What about other forms of substance abuse? 

Comments on the Quality of English Language

The english is good in terms of grammar. 

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 3 Report

Comments and Suggestions for Authors

It is a well written manuscript.

The authors analyzed the 5-year outcome of traumatic brain injured (TBI)  patients who developed epilepsy after injury. I found the article interesting because I have already dealt with both topics separately. I found the entire methodology good and well written. Do you plan to follow-up in the future beyond 5 years? 10-20 years? I actually have one question: did you also look at the genetic background of these patients? If you have such data, for example,  an epilepsy panel, are there common genes that can predispose them to epilepsy?

Author Response

Please see the attachment.

Author Response File: Author Response.docx

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

I thank the Authors for addressing all my concerns. In my opinion the paper is improved and it is suitable for publication in the present form.