Traumatic brain injury and epileptic seizures

Abstract

Post-traumatic seizures (PTS) are a complication of head injury and are classified according to the latency of the trauma. The overall incidence of PTS is around 2-5% including mild head injury. The incidence in severe head trauma is higher, about 15-20% and this proportion is even higher (35-50%) in the case of open head injuries. Regarding age there are two other important differences, the most evident of which is the greater percentage of early seizures in children, even after mild head injury. It has been reported that 75% of PTS are of focal type, mostly with secondary generalization. More frequently early seizures are of generalized type, while late seizures are of focal type. Generalized seizures are more often observed in cases of severe and diffuse head contusion, while the lesions responsible for partial seizures are subdural hematomas. As stated, there are many studies considering intracranial blood extravasation as a significant risk factor for post traumatic epilepsy (PTE). The hemoglobin deposit and later the ensuing hemosiderin deposit are considered to be the main histopathological finding of PTE. Treatment lines must take into account the likely benefits and risks in terms of adverse behavioral effects. Finally, assessment of each patient's risks and suitability for treatment must be made on an individual basis, guidelines or algorithms notwithstanding. Referral to specialty centers for the appropriate care of patients with seizures is recommended.