A Delayed Consequence of Head Trauma: Epilepsy

According to the U.S. Center of Disease Control and Prevention, 2.3 million adults and nearly 470,000 children have epilepsy in the United States. Epilepsy refers to a tendency to have chronic and recurrent seizures, which are temporary disturbances in brain functioning where nerve cells signal excessively and abnormally. Seizures can last for a matter of seconds or up to several minutes, and they can produce changes in sensation, awareness, or behaviors while also causing involuntary movements.

There are several different types of epilepsy, and while many people are born with the condition, others may develop it later in life as a result of illness, injury, or trauma. A seizure does not always indicate epilepsy, as a single seizure may be the result of a temporary medical condition. Low blood sugar, a high fever, and drug or alcohol withdrawal are all circumstances in which a seizure can be produced. In these situations, there is not usually a need for ongoing epilepsy treatment since there is no underlying medical condition.

If you have experienced a head injury or traumatic brain injury, it is important to visit a doctor right away. Post-traumatic seizures are common within a week of a TBI, and if the seizures continue after a week, you may have developed post-traumatic epilepsy. Likewise, you may not notice symptoms of post-traumatic epilepsy for several months after your head trauma, so it is essential that you know what to look for and when to seek medical attention.

A Delayed Consequence of Head Trauma:  Epilepsy

An Overview of Epilepsy

Each year, doctors diagnose 180,000 people with epilepsy, and about 30% of those patients are children. For about 50% of people who are diagnosed with the condition, an exact cause cannot be identified. There are a variety of factors that are thought to play a role:

  • Genetics. Certain types of epilepsy run in families, so there is a strong genetic influence associated with them. Researchers believe that up to 500 genes may be linked to the condition. Additionally, certain genes could also cause a person to be more sensitive to conditions that trigger seizures.
  • Prenatal injury. While in the womb, babies are very sensitive to brain damage, and this damage could be caused by poor nutrition, a lack of oxygen, or an infection experienced by their mother. Head injuries or a lack of oxygen during birth can also contribute.
  • Brain conditions. Certain brain conditions that cause damage to the brain can also cause epilepsy, including strokes and tumors. For adults over the age of 35, a stroke is the most likely cause of epilepsy.
  • Disease. Certain diseases, including viral encephalitis, meningitis, and AIDS can result in the development of epilepsy, as can abnormal levels of blood sugar, sodium, and other substances in the body.
  • Head injury. Trauma to the head that results from a car accident, work-related accident, or other traumatic event can lead to epilepsy.

Since epilepsy results from abnormal brain cell activity, seizures may affect any process that is coordinated by the brain. Symptoms can include staring spells, confusion, uncontrollable jerking movements, and loss of consciousness and awareness. However, symptoms will vary depending on the kind of seizure, but since most people experience the same variety of seizure during each episode, symptoms should be similar with each seizure.

Most people who are diagnosed with epilepsy are able to control their seizures through the use of medications known as anti-epileptic medication. For others, this medication will reduce the intensity and frequency of the seizures without stopping them completely. However, it can be a complicated process to find the right medication and dosage, and side effects like fatigue, dizziness, decreased bone density, and loss of coordination can all be experienced.

Epilepsy Causes – Various factors can contribute to the development of epilepsy.

Epilepsy Foundation – What to expect with different types of epileptic seizures.

Living with Epilepsy – Living and coping with epilepsy.

Epilepsy Treatment Options – Medication, surgery, and therapies are used to treat epilepsy.

Alternative Epilepsy Treatments – Using alternative medicine to treat epileptic seizures.

Post-Traumatic Epilepsy

Post-traumatic epilepsy, or PTE, is a recurrent disorder involving seizures that result from a traumatic brain injury (TBI). People with PTE will suffer chronic post-traumatic seizures for more than a week after the initial head injury. It is estimated that PTE accounts for 5% of all epilepsy cases, and not all people who experience a TBI will develop epilepsy. While the connection is not well-understood, certain types of injuries have a higher risk of developing PTE:

  • 65% of people who develop brain injuries as a result of a bullet wound experience seizures.
  • 20% of people who experience “closed head injuries” resulting in a bleed between the skull and the brain have seizures.
  • 35% of people who require at least two brain surgeries after a TBI will experience seizures.

In order to receive a diagnosis of PTE, a person will need to have a history of trauma to the head with no seizure history before the injury. Experiencing a seizure is the most reliable way to diagnose PTE, but in some cases, it may take months for a seizure to occur after the original injury. In fact, about 20% of people who had experienced a TBI and had a normal EEG three months after the injury were later diagnosed with PTE. However, in order for seizures to be diagnosed as PTE, all other possible causes must be ruled out, such as fluid and electrolyte imbalances and epilepsy from hypoxia.

Stanford Epilepsy Center – Epilepsy can be a delayed consequence of head trauma.

Post-Traumatic Seizures – One out of every ten people hospitalized with a TBI will experience seizures.

PTE Research – Research is needed to better understand post-traumatic epilepsy.

Incidence of Post-Traumatic Seizures – Understanding the incidence and risk factors of PTE.

Traumatic Brain Injury and Seizures – The connection between TBIs and seizures.

A Delayed Consequence of Head Trauma:  Epilepsy

Conclusion

There are numerous factors associated with development of epilepsy. While many people are born with the condition, just because you didn’t have it as a child doesn’t mean that you won’t have epilepsy as an adult. Disease, brain conditions, and head injuries can all result in late-onset epilepsy. Fortunately, medications have been quite successful at preventing or minimizing seizures, so many of the different types of epilepsy are well-controlled once the correct combination of medications has been found.

Post-traumatic epilepsy is one of the most complicated types of epilepsy, and it may be the one that is understood the least. Not all people who experience trauma to the head will develop epilepsy, but the more severe the injury is, the greater the risk of developing epilepsy will be. More people experience seizures immediately after a traumatic brain injury, but if the seizures don’t continue at least a week after the incident, the condition is not necessarily considered to be epileptic.

If you experience a head injury, especially at work, you should seek medical treatment. Help should be sought immediately if you experience sudden drowsiness, a loss of consciousness, confusion, a worsening headache, or vomiting. Likewise, convulsions, problems moving correctly, and dizziness could also be the signs of a serious problem. By seeking assistance as soon as possible, you can help to minimize the damage caused by your head injury, and you can also discuss what signs and symptoms to watch out for regarding possible post-traumatic seizures and epilepsy.

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