Recently I was asked if I knew how many veterans in the United States are seizing. The question is clear, concise, and should be easily answered. In fact, the answer is just as simple: No one knows how many veterans are actually seizing. No one even has a clue.
The photos and captions below are found at http://www.nydailynews.com/news/politics/sen-schumer-calls-canyon-heroes-parade-iraq-afghanistan-vets-article-1.1755348 and are used to illustrate the massive numbers of veterans living in the Unted States. The pictures show only thousands of the 26 Million veterans that are American's Heroes.
While we cannot come to a definitive number of veterans seizing, we can, however, make a few assumptions by looking at other things. For example, the Southeast Regional VA Epilepsy Center of Excellence (ECoC) in Durham, NC reported they served more than 87,000 veterans with seizures. This report did not, however, differentiate between epileptic and non-epileptic seizures. If you dig deeply enough in each of the ECoE literature, you may find their number. The problem with this is there are 4 regions and 16 total sites for the ECoE, and you cannot count on any of them to give detailed information about the veterans they are serving.
Trying to navigate the labyrinth of data the VA provides is extremely difficult and, in reality, may not be that useful anyway. The United States is home to more than 21.6 million veterans. The VA, however, only serves 5,908,042. That is it! Out of 21.6 million veterans, only 27% are enrolled with the VA. So regardless of how many hours are invested in searching the VA databases, the results represents a small number of veterans. There is absolutely no way to track how many of the 15,711,689 (73%) of those not using the VA Health Care System are seizing? We have no idea what is happening with 73% of our American veterans! (http://fas.org/sgp/crs/misc/R43579.pdf)
Perhaps the best way to get an idea of how many veterans in the United States is to look closely at the past. The Vietnam Head Injury Study (VHIS) has been being conducted for more than 40 years now. It is considered to be the longest, most statistically relevant study of military head injuries. You can Google it, but here is an article published in Frontiers in Neurology in 2011 (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3093742/). The authors’ state,
Previous studies of World War Two (Walker and Jablon, 1961) and Korean War veterans (Weiss and Caveness, 1972) had confirmed the association between post-traumatic seizures and penetrating TBI. At PH2, of the 421 veterans who had sustained a TBI, 53% had a history of PTE, which had started within a year of TBI in the majority of cases (Salazar et al., 1985). About one-half of the group were still experiencing seizures 15 years after injury.
These numbers seem to indicate the “official” numbers being reported today about veterans and seizures are extremely deflated. The VHIS study began with 1221 veterans, so 421 represents about 34% sustained a head injury (compare this number to the 25% or less number being thrown around by DOD…and the head injury was not the signature injury of the Vietnam conflict. Plus of the numbers we are being given today, 53% is only the worst of the worst scenarios. Yet, the VHIS states 53% of ALL who sustained a head injury (no separation of mild, moderate, and severe) developed PTE.
When we combine whatever number we can get from the VA ECoE and the results of the Vietnam Head Injury Study, the prevalence reality is far worse than we ever imagined. Now include the March 2015 report on Epilepsy from the Centers of Disease Control (CDC) that more than doubled the numbers of their previous report on people living with epilepsy (“When counting both children and adults, about 5.1 million people in the United States have had a diagnosis of epilepsy or a seizure disorder”; http://www.cdc.gov/epilepsy/basics/fast-facts.htm). The numbers become even more staggering.
Finally consider the fact that the Department of Defense (DOD) and the VA use both Social Work Clinicians (LCSW) and Licensed Professional Clinical Counselors (LPCC) to treat veterans with Post Traumatic Stress Disorder and Traumatic Brain Injury. Neither the LCSW’s nor the LPCC’s have any medical training whatsoever. In the last two years of my full-time work with the clinicians, NOT ONE had ever heard of Post Traumatic Epilepsy or Psychogenic Non-epileptic Seizures…not even the Ph.D. level Director of Mental Health Clinicians at a Warrior Transition Battalion had ever heard of them. So, I wonder how many seizures are being missed because the clinicians have no idea that panic attacks, hallucinations, etc. are not necessarily JUST symptoms of mental health issues.
While we cannot determined the exact number of veterans that are experiencing seizures, considering the information above we can be relatively certain the number of veterans seizing is exponentially more than what we read or hear about.
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