# Predicting Post-Traumatic Epilepsy from Clinical Records using Large Language Model Embeddings

arXiv: https://arxiv.org/abs/2604.14547 · HTML: https://mlsanity.com/paper/2604.14547/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 20 of its 46 references that are in the map.
- First posted on arXiv 16 Apr 2026.

## Builds on (most cited first, 20 of 20)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [BERT: Pre-training of Deep Bidirectional Transformers for Language Understanding](https://mlsanity.com/paper/1810.04805/) (2018)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [Sentence-BERT: Sentence Embeddings using Siamese BERT-Networks](https://mlsanity.com/paper/1908.10084/) (2019)
- [XGBoost: A Scalable Tree Boosting System](https://mlsanity.com/paper/1603.02754/) (2016)
- [Qwen3 Embedding: Advancing Text Embedding and Reranking Through Foundation Models](https://mlsanity.com/paper/2506.05176/) (2025)
- [M3-Embedding: Multi-Linguality, Multi-Functionality, Multi-Granularity Text Embeddings Through Self-Knowledge Distillation](https://mlsanity.com/paper/2402.03216/) (2024)
- [Supervised Learning of Universal Sentence Representations from Natural Language Inference Data](https://mlsanity.com/paper/1705.02364/) (2017)
- [GatorTron: A Large Clinical Language Model to Unlock Patient Information from Unstructured Electronic Health Records](https://mlsanity.com/paper/2203.03540/) (2022)
- [Capabilities of Gemini Models in Medicine](https://mlsanity.com/paper/2404.18416/) (2024)
- [MedCPT: Contrastive Pre-trained Transformers with Large-scale PubMed Search Logs for Zero-shot Biomedical Information Retrieval](https://mlsanity.com/paper/2307.00589/) (2023)
- [EmbeddingGemma: Powerful and Lightweight Text Representations](https://mlsanity.com/paper/2509.20354/) (2025)
- [Representing Numbers in NLP: a Survey and a Vision](https://mlsanity.com/paper/2103.13136/) (2021)
- [Llama-Embed-Nemotron-8B: A Universal Text Embedding Model for Multilingual and Cross-Lingual Tasks](https://mlsanity.com/paper/2511.07025/) (2025)
- [CPLLM: Clinical Prediction with Large Language Models](https://mlsanity.com/paper/2309.11295/) (2023)
- [MediTab: Scaling Medical Tabular Data Predictors via Data Consolidation, Enrichment, and Refinement](https://mlsanity.com/paper/2305.12081/) (2023)
- [Emergency Department Decision Support using Clinical Pseudo-notes](https://mlsanity.com/paper/2402.00160/) (2024)
- [Recurrent Neural Networks and Long Short-Term Memory Networks: Tutorial and Survey](https://mlsanity.com/paper/2304.11461/) (2023)
- [Meta Transfer of Self-Supervised Knowledge: Foundation Model in Action for Post-Traumatic Epilepsy Prediction](https://mlsanity.com/paper/2312.14204/) (2023)
- [Generalizable Representation Learning for fMRI-based Neurological Disorder Identification](https://mlsanity.com/paper/2412.16197/) (2024)

## Built on by (most cited first, 1 of 1)

- [MorphologyFM: A Foundation Model for Morphology-Aware Representation Learning from ECG and Pulse Oximetry Waveforms](https://mlsanity.com/paper/2607.09749/) (2026)

## Abstract (arXiv)

Objective: Post-traumatic epilepsy (PTE) is a debilitating neurological disorder that develops after traumatic brain injury (TBI). Early prediction of PTE remains challenging due to heterogeneous clinical data, limited positive cases, and reliance on resource-intensive neuroimaging data. We investigate whether routinely collected acute clinical records alone can support early PTE prediction using language model-based approaches. Methods: Using a curated subset of the TRACK-TBI cohort, we developed an automated PTE prediction framework that implements pretrained large language models (LLMs) as fixed feature extractors to encode clinical records. Tabular features, LLM-generated embeddings, and hybrid feature representations were evaluated using gradient-boosted tree classifiers under stratified cross-validation. Results: LLM embeddings achieved performance improvements by capturing contextual clinical information compared to using tabular features alone. The best performance was achieved by a modality-aware feature fusion strategy combining tabular features and LLM embeddings, achieving an AUC-ROC of 0.892 and AUPRC of 0.798. Acute post-traumatic seizures, injury severity, neurosurgical intervention, and ICU stay are key contributors to the predictive performance. Significance: These findings demonstrate that routine acute clinical records contain information suitable for early PTE risk prediction using LLM embeddings in conjunction with gradient-boosted tree classifiers. This approach represents a promising complement to imaging-based prediction.