Table of Contents

Posttraumatic epilepsy

Posttraumatic seizures (PTS) are a common complication of TBI, and antiepileptic drugs are used to reduce the risk of both early seizures (occurring within the first week) and late seizures (occurring after one week and potentially leading to post-traumatic epilepsy).

Definition

Recurrent seizures more than 7 days following injury.

Key concepts

● 2 categories: early (≤ 7 days) and late (>7 days) after head trauma

anticonvulsants (AEDs) may be used to prevent early posttraumatic seizures (PTS) in patients at high risk for seizures

● prophylactic AEDs do NOT reduce the frequency of late PTS

● discontinue AEDs after 1 week except for cases meeting specific criteria

Epidemiology

Posttraumatic Epilepsy Epidemiology.

Classification

Posttraumatic seizures (PTS) are often divided (arbitrarily) into early (occurring within 1 week of injury) and late (thereafter) 1). There may be justification for a third category: “immediate”, i.e. within minutes to an hour or so.

see Late-onset posttraumatic seizures.

Early Posttraumatic seizures.

Risk factors

Posttraumatic seizures risk factors.

Management

Posttraumatic seizures management.

Books

Book Review: Posttraumatic Epilepsy: Basic and Clinical Aspects 2).

Case series

see Posttraumatic seizures case series.

References

1)
Young B, Rapp RP, Norton JA, et al. Failure of Prophylactically Administered Phenytoin to Prevent Late Posttraumatic Seizures. J Neurosurg. 1983; 58:236–241
2)
Pearce JJ 3rd, Byrne RW. Book Review: Posttraumatic Epilepsy: Basic and Clinical Aspects. Neurosurgery. 2023 May 1;92(5):e111-e112. doi: 10.1227/neu.0000000000002438. Epub 2023 Mar 16. PMID: 37756663.