{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T03:02:00Z","timestamp":1785898920521,"version":"3.56.0"},"reference-count":24,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T00:00:00Z","timestamp":1759104000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["Reports"],"abstract":"<jats:p>Background: Post-traumatic epilepsy (PTE) is a recognized complication of traumatic brain injury (TBI), yet its risk following mild and moderate TBI remains underappreciated. Although mild TBI represents the majority of cases in clinical practice, a subset of patients develop unprovoked seizures months or even years post-injury. This review aims to synthesize current evidence on the incidence and predictors of PTE in mild and moderate TBI and to propose a clinically actionable decision-support tool for early risk stratification. Methods: We performed a narrative review of peer-reviewed studies published between 1985 and 2024 that reported on the incidence, risk factors and predictive models of PTE in patients with mild (Glasgow Coma Scale [GCS] 13\u201315) and moderate (GCS 9\u201312 or imaging-positive) TBI. Data from 24 studies were extracted, focusing on neuroimaging findings, early post-traumatic seizures, EEG abnormalities and clinical risk factors. These variables were integrated into a rule-based algorithm, which was implemented using Streamlit to enable real-time clinical decision-making. The decision-support tool incorporated five domains: injury severity, early post-traumatic seizures, neuroimaging findings (including contusion location and hematoma type), clinical and demographic variables (age, sex, psychiatric comorbidities, prior TBI, neurosurgical intervention) and EEG abnormalities. Results: PTE incidence following mild TBI ranged from &lt;1% to 10%, with increased risk observed in patients presenting with intracranial hemorrhage or early seizures. From moderate TBI, incidence rates were consistently higher (6\u201312%). Key predictors included early seizures, frontal or temporal contusions, subdural hematoma, multiple contusions and midline shift. Additional risk-enhancing factors included prolonged loss of consciousness, male sex, psychiatric comorbidities and abnormal EEG patterns. Based on these features, we developed a decision-support tool that stratifies patients into low-, moderate- and high-risk categories for developing PTE. Conclusions: Even in non-severe cases, patients with mild and moderate TBI who exhibit high-risk features remain vulnerable to long-term epileptogenesis. Our proposed tool provides a pragmatic, evidence-based framework for early identification and follow-up planning. Prospective validation studies are needed to confirm its predictive accuracy and optimize its clinical utility.<\/jats:p>","DOI":"10.3390\/reports8040193","type":"journal-article","created":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T10:49:34Z","timestamp":1759142974000},"page":"193","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Post-Traumatic Epilepsy After Mild and Moderate Traumatic Brain Injury: A Narrative Review and Development of a Clinical Decision Tool"],"prefix":"10.3390","volume":"8","author":[{"given":"Ioannis","family":"Mavroudis","sequence":"first","affiliation":[{"name":"Department of Neuroscience, Leeds Teaching Hospital, NHS Trust, Leeds LS17 7HY, UK"},{"name":"Institute of Health Sciences, University of Leeds, Leeds LS2 9NL, UK"},{"name":"Third Department of Neurology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"},{"name":"Academy of Romanian Scientists, 050094 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katerina","family":"Franekova","sequence":"additional","affiliation":[{"name":"Institute of Health Sciences, University of Leeds, Leeds LS2 9NL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5617-0346","authenticated-orcid":false,"given":"Foivos","family":"Petridis","sequence":"additional","affiliation":[{"name":"Third Department of Neurology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alin","family":"Ciobica","sequence":"additional","affiliation":[{"name":"Department of Biology, Faculty of Biology, \u201cAlexandru Ioan Cuza\u201d University of Iasi, 700505 Iasi, Romania"},{"name":"CENEMED Platform for Interdisciplinary Research, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d, 700115 Iasi, Romania"},{"name":"\u201cOlga Necrasov\u201d Center, Depart of Biomedical Research, Romanian Academy, 700505 Iasi, Romania"},{"name":"\u201cIoan Haulica\u201d Institute, Apollonia University, 700511 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1962-7861","authenticated-orcid":false,"given":"Gabriel","family":"D\u0103sc\u0103lescu","sequence":"additional","affiliation":[{"name":"Department of Biology, Faculty of Biology, \u201cAlexandru Ioan Cuza\u201d University of Iasi, 700505 Iasi, Romania"},{"name":"\u201cIoan Haulica\u201d Institute, Apollonia University, 700511 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7717-1738","authenticated-orcid":false,"given":"Carmen Rodica","family":"Anton","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ciprian","family":"Ilea","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6743-6544","authenticated-orcid":false,"given":"Sotirios","family":"Papagiannopoulos","sequence":"additional","affiliation":[{"name":"Third Department of Neurology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7319-2045","authenticated-orcid":false,"given":"Dimitrios","family":"Kazis","sequence":"additional","affiliation":[{"name":"Third Department of Neurology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emil","family":"Anton","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3105","DOI":"10.1007\/s00415-020-09926-w","article-title":"A review of seizures and epilepsy following traumatic brain injury","volume":"267","author":"Fordington","year":"2020","journal-title":"J. Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Yu, T., Liu, X., Sun, L., Wu, J., and Wang, Q. (2021). Clinical characteristics of post-traumatic epilepsy and the factors affecting the latency of PTE. 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