Posttraumatic Epilepsy Clinical Presentation

Updated: Dec 06, 2017
  • Author: David Y Ko, MD; Chief Editor: Selim R Benbadis, MD  more...
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Presentation

History

Posttraumatic seizures (PTS) are usually partial (focal) or secondarily generalized tonic-clonic (bilateral tonic clonic). Often, if only the secondarily generalized seizure is reported, one can assume there was a focal onset of PTS. Most early PTS are partial seizures, whereas most late PTS, especially when in patients with posttraumatic epilepsy (PTE), are partial-onset with and without secondarily generalized seizures.

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Physical Examination

There are no specific findings noted on physical examination in some patients, but others may have some findings depending on the location and severity of the TBI, including focal deficits such as language problems, or even diffuse psychomotor slowing.

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. There could be personality changes as well as a number of problems such as posttraumatic stress disorder (PTSD), anxiety, and depression.

With TBI, many patients may have posttraumatic headaches and some could develop migraines. Should they be complex, sometimes the symptoms overlap with seizures.

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Complications

If the PTE is severe with frequent secondarily generalized seizures then the risk of sudden unexpected death in epilepsy (SUDEP) is increased.

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