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Of 392 patients surviving to discharge, cumulative incidence of post\u2010traumatic epilepsy was 25% at 5\u2009years and 32% at 15\u2009years, an increase compared with historical reports. Among patients with one late seizure (&gt;7\u2009days post\u2010trauma), the risk of seizure recurrence was 62% after 1\u2009year and 82% at 10\u2009years. Competing hazards regression identified age, decompressive hemicraniectomy, and intracranial infection as independent predictors of post\u2010traumatic epilepsy. Patients with severe traumatic brain injury and a single late post\u2010traumatic seizure will likely require long\u2010term antiseizure medicines. 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