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
- 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.