Post-traumatic seizures are recurrent seizure disorder that occurs as a sequel to brain injury. This brain injury can be traumatic or due to brain surgery.
Classification of Post-traumatic seizures
Immediate PTS: Seizures that occur within 24 hours after brain injury
Early PTS: Seizures that occur within 1 week after injury
Late PTS: Seizures that occur more than 1 week after injury
Causes of Post-traumatic seizures
The major cause of post-traumatic seizures is trauma or injury to the head or brain. But the mechanism by which trauma to brain tissue leads to recurrent seizures is unknown. Post-traumatic seizures can be due to:
Penetrating head injuries
Bullet wounds
Closed head injuries
Intracranial hematoma
Linear or depressed skull fracture
Symptoms of Post-traumatic seizures
Most of the patients experience seizures in the first several days or weeks after a brain injury. But it may also occur months or years after the injury. Symptoms include:
Partial (focal) or generalized tonic-clonic seizures characterized by strange and involuntary movement (stiffening or shaking) of head, body, arms, legs, or eyes of the patient
Unresponsiveness and staring
Severe headache
Chewing, lip smacking, or fumbling
Strange smell, sound, feeling, taste, or visual images
Sudden tiredness or dizziness
Not being able to speak, walk or understand others
Characteristics of seizure:
Sudden onset
Uncontrollable
Usually last only a few seconds or minutes and maximum 5 to 10 minute
Bladder or bowel accident
Biting of tongue or the inside of mouth
Diagnosis of post-traumatic seizure
Physical and neurological examination of the patient along with history of trauma plays major role in establishing the diagnosis of post-traumatic seizure. But this diagnosis should be verified by video-EEG monitoring.
Treatment of Post-traumatic seizure
Almost 20% of cases who have a single late posttraumatic seizure never have any further seizures, and they do not need any treatment. Early PTS should be treated promptly with antiepileptic drugs (AEDs) like Carbamazepine, Lamotrigine, and Phenobarbital etc.
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