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Post-traumatic epilepsy

Post-traumatic epilepsy
SpecialtyNeurology

Post-traumatic epilepsy (PTE) is a form of acquired epilepsy that results from brain damage caused by physical trauma to the brain (traumatic brain injury, abbreviated TBI).[1] A person with PTE experiences repeated post-traumatic seizures (PTS, seizures that result from TBI) more than a week after the initial injury.[2] PTE is estimated to constitute 5% of all cases of epilepsy and over 20% of cases of acquired epilepsy[3][4][1] (in which seizures are caused by an identifiable organic brain condition).[5]

It is not known who will develop epilepsy after TBI and who will not.[6] However, the likelihood that a person will develop PTE is influenced by the severity and type of injury; for example penetrating injuries and those that involve bleeding within the brain confer a higher risk. The onset of PTE can occur within a short time of the physical trauma that causes it, or months or years after.[3] People with head trauma may remain at a higher risk for post-traumatic seizures than the general population even decades after the injury.[7] PTE may be caused by several biochemical processes that occur in the brain after trauma, including overexcitation of brain cells and damage to brain tissues by free radicals.[8]

Diagnostic measures include electroencephalography (EEG) and brain imaging techniques such as magnetic resonance imaging, but these are not totally reliable. Antiepileptic drugs do not prevent the development of PTE after head injury, but may be used to treat the condition if it does occur. When medication does not work to control the seizures, surgery may be needed.[9] Modern surgical techniques for PTE have their roots in the 19th century, but trepanation (cutting the skull to make a hole) may have been used for the condition in ancient cultures.[10]

  1. ^ a b Brady RD, Casillas-Espinosa PM, Agoston DV, Bertram EH, Kamnaksh A, Semple BD, Shultz SR (March 2019). "Modelling traumatic brain injury and posttraumatic epilepsy in rodents". Neurobiology of Disease. 123: 8–19. doi:10.1016/j.nbd.2018.08.007. PMC 6348144. PMID 30121231.
  2. ^ Pagni CA, Zenga F (2005). "Posttraumatic epilepsy with special emphasis on prophylaxis and prevention". Acta Neurochirurgica. Acta Neurochirurgica Supplementum. 93: 27–34. doi:10.1007/3-211-27577-0_3. ISBN 978-3-211-24150-9. PMID 15986723.
  3. ^ a b Garga N, Lowenstein DH (2006). "Posttraumatic Epilepsy: A Major Problem in Desperate Need of Major Advances". Epilepsy Currents. 6 (1): 1–5. doi:10.1111/j.1535-7511.2005.00083.x. PMC 1363374. PMID 16477313.
  4. ^ Cite error: The named reference Mani06 was invoked but never defined (see the help page).
  5. ^ Scheffer IE, Berkovic S, Capovilla G, Connolly MB, French J, Guilhoto L, Hirsch E, Jain S, Mathern GW (April 2017). "ILAE classification of the epilepsies: Position paper of the ILAE Commission for Classification and Terminology". Epilepsia. 58 (4): 512–521. doi:10.1111/epi.13709. PMC 5386840. PMID 28276062.
  6. ^ Pitkänen A, Kharatishvili I, Karhunen H, et al. (2007). "Epileptogenesis in experimental models". Epilepsia. 48 (Supplement 2): 13–20. doi:10.1111/j.1528-1167.2007.01063.x. PMID 17571349. S2CID 23523719.
  7. ^ Cite error: The named reference D'AmbrosioPerucca04 was invoked but never defined (see the help page).
  8. ^ Agrawal A, Timothy J, Pandit L, Manju M (2006). "Post-traumatic epilepsy: An overview". Clinical Neurology and Neurosurgery. 108 (5): 433–439. doi:10.1016/j.clineuro.2005.09.001. PMID 16225987. S2CID 2650670.
  9. ^ Cite error: The named reference PosnerLorenzo was invoked but never defined (see the help page).
  10. ^ Cite error: The named reference Bladin01 was invoked but never defined (see the help page).
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