Seizures after traumatic brain injury pubmed central pmc. Posttraumatic seizure prophylaxis in patients with. Post traumatic seizure disorder following acquired. The risk of developing pte relates directly to tbi severity, but the latency to first seizure can be decades after the inciting trauma. Posttraumatic seizure an overview sciencedirect topics.
Objective posttraumatic epilepsy pte is a known complication of traumatic brain injury tbi. Seizure onsets can occur within weeks early seizure or months, even up to ten years after the tbibrain injury late seizures. Notably, no veterans had a history of loss of consciousness greater than 30 minutes, penetrating head wound, seizure disorder, insulin dependent diabetes, diagnosis of schizophrenia or bipolar disorder, other psychotic disorders, dementia, or alcohol. This topic will discuss epidemiologic, clinical, management and prognostic issues that are specific to posttraumatic seizures. One of the many outstanding issues is, however, if acute or early seizures are enhancers of the risk and by which factor. By definition tbi is the only direct risk factor for post traumatic epilepsy pte and this risk is well known. One study showed focal slowing persisting more than two years in 22 percent of patients, mostly in those who had developed post traumatic epilepsy. Traumatic epilepsy an overview sciencedirect topics.
A seizure is an episode of abnormal brain activity. Post traumatic epilepsy population based annegars et al. A seizure is an event when you lose control of your body and convulse, possibly also losing consciousness. What do i need to know about seizures after a traumatic brain injury tbi. Epilepsy is a condition that can make a person recurrent seizures. Post traumatic seizure disorders have been defined in the practice parameter of the antiepileptic drug treatment of post traumatic seizures. Understanding posttraumatic epilepsy epilepsy foundation. Post traumatic epilepsy refers to a recurrent seizure disorder whose cause is believed to be traumatic brain injury. Seizure prophylaxis in patients with traumatic brain injury tbi summary post traumatic seizures pts are common complications of tbi. There may be justification for a third category of immediate seizure, occurring minutes to. Seizures after traumatic brain injury what you need to know.
Post traumatic epilepsy can result from traumatic brain injury tbi due to a number immediate and chronic changes to the cellular environment in the affected tissues. Post traumatic epilepsy can develop years after a traumatic brain injury and is a major concern for those in the military. Post traumatic stress disorder following tbi and the neurologicpsychiatric borderland. Can indulgence in some sports make seizures potentially worse vs could some sports actually be beneficial for people with epilepsy physically and psychologically. Over 40% of combat troops who suffer severe traumatic brain injury are at risk of developing pte, which can deeply impact their recovery process and create lifelong challenges. Pte is one of the most common types of acquired or secondary epilepsies, which are due to a brain insult, such as trauma, tumors, stroke, and infections, and accounts for 20% of acquired epilepsy in the general population. The incidence of posttraumatic epilepsy varies widely among clients with traumatic brain injury depending upon the type and severity of the injury as well as on other related factors, including the patients age. Ct scan is a useful modality in identifying the probability of late pts. About 25% of people who have an early post traumatic seizure will have another seizure months or years later. Can indulgence in some sports make seizures potentially worse vs could some sports actually be beneficial for people with epilepsy. Post traumatic seizures pts, although identified as a serious consequence of traumatic brain injury tbi, remain an understudied problem ferguson et al. Post traumatic epilepsy pte is a recurrent seizure disorder secondary to traumatic brain injury tbi.
Seizures are a long recognized complication of traumatic brain injury tbi. A seizure that occurs in the immediate aftermath of a head injury is a risk factor for post traumatic epilepsy. Pte refers to recurrent and unprovoked pts that occur at least 1 week after tbi. Although most people who have a brain injury will never have a seizure, it is. Early and late posttraumatic epilepsy in the setting of traumatic brain injury. Early and late post traumatic epilepsy in the setting of traumatic brain injury. Pdf posttraumatic seizures pts and posttraumatic epilepsy pte are complications from traumatic brain injury tbi. One of the problems that can occur after a traumatic brain injury tbi is seizures. Seizures after traumatic brain injury model systems. Traumatic brain injury and psychogenic seizures 1222012 martin salinsky m.
Pts are seizures occurring in the first week after tbi, and are considered to be. Early pts are linked to a high incidence of late pts and chronic epilepsy. Post traumatic seizure disorders have been defined in the practice parameter of the antiepileptic drug treatment of post traumatic seizures by the. But a new study showed that more than twice as many veterans 56% as civilians 26% had suspected a preceding head injury as the cause of the seizures. Pdf posttraumatic epilepsy pte is one of the most debilitating and understudied consequences of traumatic brain injury tbi. A traumatic brain injury may give rise to seizures and epilepsy, with the likelihood of developing seizures related to the severity of the injury.
Epilepsy from head trauma is symptomatic epilepsy, where the attack can be partial focal or general attack or mixed form. The use of levetiracetam for post traumatic seizure prophylaxis has been increasing, presumably. Analyzing risk factors for late posttraumatic seizures archives of. The terms post traumatic epilepsy pte and post traumatic seizures pts are both used to describe seizures that happen because of a tbi. Candoes mild tbi sustained while playing contact sports lead to post traumatic seizures epilepsy. Windows to the brain the journal of neuropsychiatry. Epidemiology post traumatic epilepsy pte is the most frequent cause. Post traumatic epilepsy is determined by the presence of late seizures and therefore unprovoked. Epilepsy tbi severity 87% 14% 37% 63% 0% 20% 40% 60% 80% mild tbi moderatesevere tbi nts psychogenic epileptic p seizures u.
Post traumatic seizures pts and post traumatic epilepsy pte are complications from traumatic brain injury tbi. The likelihood of developing post traumatic epilepsy after a tbi is higher with greater severity of the trauma, for example penetrating head injuries, when there is intracranial hematomas bleeding, depressed skull fractures, a coma lasting more than 24 hours, and early seizures. Post traumatic seizures are a recognized complication of tbi. Pte and post traumatic seizures pts have both been used to describe seizures occurring after head trauma that are believed to be causally related to the trauma itself. There may be justification for a third category of immediate seizure, occurring minutes to hours after injury. An overview among this group of people, measuring the incidence of post traumatic seizures has been difficult taking into account the incidence of epilepsy in the general population, the presence of other risk factors, failure to exclude all acute symptomatic seizures.
Background late posttraumatic seizures are a common complication of moderate and severe traumatic brain injury. Posttraumatic epilepsy pte is a lifelong complication of traumatic brain injury tbi. As is true for non traumatic epilepsy, imaging mri often. Posttraumatic epilepsy contributes significantly to the functional disability in a tbi survivor. Use of antiepileptics for seizure prophylaxis after. Increased risk of late posttraumatic seizures associated. Seizures during the first week after tbi are considered provoked, an acute complication from head injury, while. Posttraumatic epilepsy pte is a form of acquired epilepsy that results from brain damage caused by physical trauma to the brain traumatic brain injury, abbreviated tbi. About 12% of patients with severe tbi develop post traumatic seizures, and the rate may be more than 50% for those with penetrating missile injuries. A seizure in the first week after a brain injury is called an early post traumatic seizure. Post traumatic seizures and epilepsy in zasler nd, katz di, zafonte rd, brain injury medicine. Posttraumatic epilepsy pte is a form of symptomatic epilepsy defined by the presence of recurrent seizures secondary to traumatic brain.
Post traumatic epilepsy contributes significantly to the functional disability in a tbi survivor. It is a common form of epilepsy, and develops in a variable proportion of traumatic brain injury survivors depending on the severity of the injury and the time after injury. This topic will discuss epidemiologic, clinical, management and prognostic issues that are specific to post traumatic seizures. Pdf modelling traumatic brain injury and posttraumatic. Clinical approach to posttraumatic epilepsy thieme connect. Pts may be a risk factor for post traumatic epilepsy pte, but a person who has a seizure or seizures due to traumatic brain injury does not necessarily have pte, which is a form of epilepsy, a chronic condition in which seizures occur repeatedly. In up to twothirds of patients, late post traumatic seizures are generalized or focal with secondary gener alization, and often both seizure types may coexist.
Psychogenic nonepileptic seizures are associated with mild. Post traumatic seizures pts are seizures that result from traumatic brain injury tbi, brain damage caused by physical trauma. Seizures that occur early versus late after tbi have different. Posttraumatic stress disorder following tbi and the. Epilepsy can follow traumatic brain injury features. Post traumatic stress disorder may contribute to psychogenic seizures psychogenic seizures are just as common in veterans as they are in civilians. Posttraumatic seizures pts and posttraumatic epilepsy pte are complications from traumatic brain injury tbi. More general issues related to seizures and epilepsy are discussed elsewhere.