Posttraumatic Epilepsy Clinical Presentation
- Author: Ewa Posner, MD, MRCP; Chief Editor: Selim R Benbadis, MD more...
History
Posttraumatic seizures (PTS) are usually partial (focal) or generalized tonic-clonic. Often, both types coexist. Most early PTS are partial seizures, whereas most late PTS, especially when in patients with posttraumatic epilepsy (PTE), are generalized and either primary or partial-onset.
Physical Examination
No specific findings are noted on physical examination.
Posttraumatic status epilepticus is a complication of PTE. It is more common in children than in adults.
Psychological problems related to social isolation and the stigma of epilepsy are common in PTE.
Frey LC. Epidemiology of posttraumatic epilepsy: a critical review. Epilepsia. 2003;44 Suppl 10:11-7. [Medline].
D'Ambrosio R, Perucca E. Epilepsy after head injury. Curr Opin Neurol. Dec 2004;17(6):731-5. [Medline].
Diaz-Arrastia R, Gong Y, Fair S, Scott KD, Garcia MC, Carlile MC, et al. Increased risk of late posttraumatic seizures associated with inheritance of APOE epsilon4 allele. Arch Neurol. Jun 2003;60(6):818-22. [Medline].
Anderson GD, Temkin NR, Dikmen SS, Diaz-Arrastia R, Machamer JE, Farhrenbruch C. Haptoglobin phenotype and apolipoprotein E polymorphism: relationship to posttraumatic seizures and neuropsychological functioning after traumatic brain injury. Epilepsy Behav. Nov 2009;16(3):501-6. [Medline].
Chamelian L, Reis M, Feinstein A. Six-month recovery from mild to moderate Traumatic Brain Injury: the role of APOE-epsilon4 allele. Brain. Dec 2004;127:2621-8. [Medline].
Annegers JF, Hauser WA, Coan SP, et al. A population-based study of seizures after traumatic brain injuries. N Engl J Med. Jan 1 1998;338(1):20-4. [Medline].
Angeleri F, Majkowski J, Cacchio G, et al. Posttraumatic epilepsy risk factors: one-year prospective study after head injury. Epilepsia. Sep 1999;40(9):1222-30. [Medline].
Raymont V, Salazar AM, Lipsky R, Goldman D, Tasick G, Grafman J. Correlates of posttraumatic epilepsy 35 years following combat brain injury. Neurology. Jul 20 2010;75(3):224-9. [Medline]. [Full Text].
Skandsen T, Ivar Lund T, Fredriksli O, Vik A. Global outcome, productivity and epilepsy 3--8 years after severe head injury. The impact of injury severity. Clin Rehabil. Jul 2008;22(7):653-62. [Medline].
Hudak AM, Trivedi K, Harper CR, Booker K, Caesar RR, Agostini M, et al. Evaluation of seizure-like episodes in survivors of moderate and severe traumatic brain injury. J Head Trauma Rehabil. Jul-Aug 2004;19(4):290-5. [Medline].
Temkin NR, Dikmen SS, Wilensky AJ. A randomized, double-blind study of phenytoin for the prevention of post-traumatic seizures. N Engl J Med. Aug 23 1990;323(8):497-502. [Medline].
Löscher W, Brandt C. Prevention or modification of epileptogenesis after brain insults: experimental approaches and translational research. Pharmacol Rev. Dec 2010;62(4):668-700. [Medline]. [Full Text].
[Guideline] Chang BS, Lowenstein DH. Practice parameter: antiepileptic drug prophylaxis in severe traumatic brain injury: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. Jan 14 2003;60(1):10-6. [Medline].
Beghi E. Overview of studies to prevent posttraumatic epilepsy. Epilepsia. 2003;44 Suppl 10:21-6. [Medline].
Schierhout G, Roberts I. Anti-epileptic drugs for preventing seizures following acute traumatic brain injury. Cochrane Database Syst Rev. 2001;CD000173. [Medline].
Szaflarski JP, Sangha KS, Lindsell CJ, Shutter LA. Prospective, randomized, single-blinded comparative trial of intravenous levetiracetam versus phenytoin for seizure prophylaxis. Neurocrit Care. Apr 2010;12(2):165-72. [Medline].
Temkin NR. Prophylactic Anticonvulsants After Neurosurgery. Epilepsy Curr. Jul 2002;2(4):105-107. [Medline].
Milligan TA, Hurwitz S, Bromfield EB. Efficacy and tolerability of levetiracetam versus phenytoin after supratentorial neurosurgery. Neurology. Aug 26 2008;71(9):665-9. [Medline].
Temkin NR, Dikmen SS, Anderson GD, et al. Valproate therapy for prevention of posttraumatic seizures: a randomized trial. J Neurosurg. Oct 1999;91(4):593-600. [Medline].
Mori A, Yokoi I, Noda Y, Willmore LJ. Natural antioxidants may prevent posttraumatic epilepsy: a proposal based on experimental animal studies. Acta Med Okayama. Jun 2004;58(3):111-8. [Medline].

