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Understanding Post-traumatic Epilepsy: Symptoms and Treatment

Sandeep Dhanyamraju MD
Medically reviewed by Sandeep Dhanyamraju
Sandeep Dhanyamraju MD
Medically reviewed by Sandeep Dhanyamraju

Post-traumatic epilepsy is a condition that affects people who have traumatic brain injuries(TBIs). Up to 5% of individuals who suffer from TBI will develop PTE. It can significantly impact their quality of life. PTE can occur immediately after the injury or may take several years to develop.

Symptoms of PTE can vary widely and may include:

  • seizures;
  • memory problems;
  • mood changes;
  • difficulty concentrating.

These symptoms can be debilitating. They can significantly affect an individual’s ability to carry out daily activities.

Various treatment options are available for seizure after a head injury, including medication, surgery, and other therapies. But, finding the right treatment plan can be challenging. As each individual’s symptoms and response to treatment can differ.

In this article, we will explore the symptoms of PTE. Also, we will discuss the different treatment options available. We will also examine the question if concussions can cause epilepsy. You may also find tips for managing the condition.

Post-traumatic epilepsy definition

TBI seizures  is a chronic condition characterized by recurrent unprovoked epileptic seizures. They are causally linked to a history of brain injury (traumatic brain injury).

The incidence of PTE in previous traumatic brain injury cases is easily found in many studies to be 5-50%. And its course is often progenerative. It depends on the severity of the trauma and its complications. Doctors must make a clear description of post-traumatic seizures symptoms:

  • Seizures that occur within 24 h after a traumatic brain injury are immediate. Of all seizures within the first week of craniocerebral trauma, about 50% occur within the first 24 h.
  • Seizures that develop during the first week after injury are early. According to the study, early seizures occur in 2 to 17% of all trauma patients. They are more common in children than adults. And their frequency correlates with the severity of the trauma. Early seizures after severe traumatic brain injury are usually higher:
  • 10 to 15% for adults; 
  • 30 to 35% for children.
  • Seizure after head injury with manifestation from day eight and after a traumatic event is late. The International League Against Epilepsy (ILAE) classifies immediate and early seizures as:
  • “situationally conditioned”;
  • “acute symptomatic.”

So they do not need a diagnosis of epilepsy.

It is reasonable to diagnose PTE only in persons with recurrent unprovoked SE. They had suffered head trauma more than seven days before the onset of SE. But a single SE after a CHT cannot be epilepsy. PTE forms:

  • earlier after a severe concussion (about a year later);
  • later (two years or more) after a concussion.

The main risk factors for TBI seizures, according to studies, are: 

  • age less than five years;
  • severe degree of trauma;
  • penetrating trauma;
  • intracranial hematoma requiring neurosurgical intervention;
  • linear or depressed skull fracture;
  • hemorrhagic brain contusion;
  • coma lasting more than 24 hours;
  • early post-traumatic seizures;
  • focal changes on neuroimaging or EEG during the acute period of trauma.

post traumatic seizures symptoms

Post-traumatic seizures symptoms

The most characteristic manifestation of epilepsy following a brain injury is seizures. Most often, they occur after:

  • stressful situations;
  • ingestion of alcohol;
  • physical overload.

Symptoms in seizures usually depend on which brain area has pathological activity.

Seizures can occur in specific muscle groups. They spread in a sequence. It corresponds to the location of motor centers in the precentral gyrus. The seizure proceeds without loss of consciousness.

After the seizure, paresis of the limb in which the seizure occurred is present.

At the height of the seizure, the patient may:

  • lose consciousness;
  • generalized convulsions develop. 

Changes in vision, hearing or other senses may also occur during post-traumatic epilepsy. The individual may experience:

  • visual or auditory hallucinations;
  • changes in their sense of touch or taste. 

They may also experience a sensation of numbness or tingling in their limbs. Another variant of a seizure is local paresthesias.

Besides convulsive seizures in such patients are present:

  • mental disturbances.
  • instability of character.
  • lability of mood.
  • weakening of memory.
  • impaired criticism.
  • progressive dementia.

Often, precursor symptoms of a painful condition occur before an attack. These are called the aura.

Common manifestations of the aura are:

  • nausea;
  • severe anxiety for no clear reason;
  • poor appetite;
  • pain in the stomach;
  • insomnia;
  • headache;
  • severe irritability.

It is important to note that not all individuals who experience TBI seizures will develop PTS. But, people who have experienced a TBI are at a higher risk of developing seizures. That’s why they should seek medical attention if they experience any described symptoms.

How can concussions cause epilepsy

It can occur as they damage the brain in ways that make it more susceptible to seizures. A concussion is a type of seizure after head injury:

  • It occurs when the brain is pushed or concussed inside the skull.
  • It can cause the brain to swell or bleed, leading to brain activity and connectivity changes.

One of the ways concussions can lead to epilepsy is by causing the formation of scar tissue in the brain. Scar tissue can disrupt the brain’s normal functioning:

  • It creates areas of abnormal electrical activity that can trigger seizures. This type of epilepsy is known as post-traumatic epilepsy (PTE). 
  • It can develop months or even years after the initial concussion.

Another way concussions can cause epilepsy is by altering the brain’s chemical balance. A concussion can cause an increase in the production of certain chemicals in the brain. For example, it can be glutamate, which can cause damage to brain cells and increase the risk of seizures. 

The severity and frequency of concussions can increase the likelihood of developing epilepsy.

What to do with a seizure after a head injury

Taking specific steps to ensure their safety is essential after a seizure. Here are some steps you can take:

  1. Ensure safety. The priority is to protect the person from harm. So remove any sharp or dangerous objects nearby that may cause injury. Also, make sure there are no hard surfaces or sharp corners nearby.
  2. Ease the person to the ground. Gently guide them to the ground so they don’t fall, hit their head, or cause harm.
  3. Loosen any tight clothing. If the person is wearing tight clothing, such as a belt or tie, loosen them. You need it to ensure they can breathe comfortably during post-traumatic epilepsy.
  4. Turn the person to the side. This can help prevent choking or aspiration if the person vomits or has much saliva in their mouth. It also helps clear their airway to breathe more easily.
  5. Do not restrain the person. Although watching someone having a seizure can be distressing, do not restrain them. As it can cause further injury.
  6. Time the seizure. It’s important to time the seizure as it can help medical professionals understand the severity and length of the seizure.
  7. Seek medical attention. Call for emergency medical services or take the person to the nearest hospital very fast. Do it, especially if:
  • the seizure lasts longer than 5 minutes;
  • the person has multiple TBI seizures;
  • they experience breathing difficulties.
  1. Reassure the person. If the person is conscious, reassure them that they are safe and that you are there to help them.
  2. Provide relevant information to medical professionals. Be sure to inform medical professionals about the head injury and any other relevant medical history, such as whether the person has a history of seizures or epilepsy.
  3. Follow-up with medical care. After medical attention, following up with the person’s healthcare provider is important. The healthcare provider can recommend tests to determine the extent of the injury. Also, they may prescribe medication or other treatments.

In summary, the most important thing to remember when dealing with a seizure after a head injury  is to prioritize the person’s safety and seek medical attention immediately. Keep calm, reassure the person and follow the advice of medical professionals. Remember that you can find a high-qualified medical help from Lone Star Neurology.

FAQ 

  • Does post-traumatic epilepsy go away?

No, post-traumatic epilepsy may not go away completely. It can be a lifelong condition that requires ongoing management. While some people may experience spontaneous remission, for others, post-traumatic epilepsy can be a lifelong condition that requires ongoing management with medication and other therapies.

  • How is post-traumatic epilepsy diagnosed?

The doctor diagnoses it by analyzing the history of trauma that led to the disease and data on how often seizures occur, what triggers them, and how long they last. EEG or electroencephalography records brain biopotentials, and MRI of the brain are assigned as instrumental examinations.

  • What are post-traumatic seizures?

Post-traumatic seizures can occur after a traumatic brain injury (TBI). They may occur within the first few days after the injury or weeks to months later. Post-traumatic seizures are a common complication of TBI, affecting around 5% to 7% of people who have suffered a traumatic brain injury.

  • Can post-traumatic epilepsy develop immediately after a head injury?

No, post-traumatic epilepsy may not develop immediately after a head injury. It can occur weeks, months, or even years after the injury, making it important to monitor for symptoms and seek medical attention if they occur.

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Edward Medina
Edward Medina
15:34 30 Jun 22
Just such an amazing staff that makes you feel like part of their family. I’ve been going there for over 5 years now... and each visit I get the very best care and treatments that I have ever received in the 20+ years that I’ve been dealing with severe debilitating migraines. Since i started seeing them the number of my migraines has dropped from 15-20 a month to 2-3 every 3 month. I highly recommend them …they will change your life!read more
Daneisha Johnson
Daneisha Johnson
22:20 19 May 22
Dr. Askari was very kind and explained everything so I could understand. The other staff were nice as well. I would... have gave 5 stars but I was a little taken aback when I checked in and had to pay 600.00 upfront. I think that should have been discussed in a appointment confirmation call or email just so I could have been prepared.read more
Jean Cooper
Jean Cooper
16:54 29 Apr 22
I love the office staff they are friendly and very helpful. Dr. JODIE is very caring and understanding to your needs... and wants to help you. I will go back. would recommend Dr. Dr. Jodie to other Patients in a heart beat. The team works well together.read more
Linda M
Linda M
19:40 02 Apr 22
I was obviously stressed, needing to see a neurologist. The staff was so patient and Dr. Ansari was so kind. At one... point he told me to relax, we have time, when I was relaying my history of my condition. That helped ease my stress. I have seen 3 other neurologists and he was the only one who performed any assessment tests on my cognitive and physical skills. At one point I couldn't complete two assessments and got upset and cried. I was told, it's OK. That's why you're here. I was truly impressed, and super pleased with the whole experience!read more
Leslie Durham
Leslie Durham
15:05 01 Apr 22
I've been coming here for about 5 years. The staff are ALWAYS friendly and knowledgeable. The Doctors are the absolute... best!! Jodie Moore is always in such a great mood which is a plus when you are already stressed. Highly recommendedread more
Monica Del Bosque
Monica Del Bosque
14:13 25 Mar 22
Since my first post my thoughts have changed here. It's unfortunate. My doctor and PA were great, but the office staff... is horrible. They never call you back when they say they will, they misinform you, they cause you too much stress wondering what's going on, they don't keep you posted. They never answer the phone. At this point I've left four messages in the last week, and I have sent three messages. Twice from their portal and one direct email. No response. My appointment is on Monday morning at 8:30am, no confirmation on my insurance and what's going on. What the heck is going on, this is ridiculous!I've given up... the stress her office staff has put me through is just not worth it. You can do so much better, please clean house, either change out your office staff, or find a way for them to be more efficient please. You have to do something. This is not how you want to run your practice. It leaves a very bad impression on your business.read more
Ron Buckholz
Ron Buckholz
23:32 23 Mar 22
I was actually pleasantly surprised with this visit! It took me a long time to get the appointment scheduled because no... one answers your phones EVER! After a month, I finally got in, and your staff was warm, friendly, and I was totally impressed! I feel like you will take care of my needs!read more
Steve Nabavi
Steve Nabavi
16:28 16 Mar 22
It was a nice visit. Happy staff doing all they can do to comfort the patients in a very calming environment. You ask... me they are earned a big gold star on the fridge. My only complaint they didn't give me any cookies.read more
Katie Lewis
Katie Lewis
16:10 10 Feb 22
Had very positive appointments with Jodie and Dr. Sheth for my migraine care. Jodie was so fast with the injections and... has so much valuable info. I started to feel light headed during checkout and the staff was SO helpful—giving me a chair, water, and taking me into a private room until I felt better. Highly recommend this practice for migraine patients, they know what they’re doing!!read more
Joshua Martinez
Joshua Martinez
16:02 10 Dec 21
I was scheduled to be checked and just want to say that the staff was fantastic. They were kind and helpful. I was... asked many questions related to what was going on and not once did I feel as though I was being brushed off. The front desk staff was especially great in assisting me. I'm scheduled to go back for a mri and am glad that I'll be going there.read more
Isabel Ivy
Isabel Ivy
21:42 03 Nov 21
I had such a good experience with Lone Star Neurology, Brent my MRI Tech was so awesome and made sure I was very... comfortable during the appointment. He gave me ear plugs, a pillow, leg support and blanket, easiest MRI ever lol 🤣 My 72 hour EEG nurse Amanda was also so awesome. She made sure I was take care of over the 3 days and took her time with the electrodes to make sure it was comfortable for me! Paige was also a huge help in answering all my questions when it came to my test results, and letting me know her honest opinions about how I should go forth with my treatment.read more
Leslie Luce
Leslie Luce
17:37 20 Oct 21
The professionalism and want to help attitude of this office was present from the moment I contacted them. The follow... up and follow through as well as their willingness to find a way to schedule my dad was above and beyond. We visited two offices in the same day with the same experience. I am appreciative of this—we spend a lot of time with doctors and this was top notch start to finish.read more
robert Parker
robert Parker
16:38 16 Apr 21
I love going to this office. The staff is friendly and helpful. The doctor is great. I am getting the best... neurological tests and treatment I have ever had. The only reason I did not give them a 5 star rating is because it is impossible to reach a live person at the office to reschedule appointments. Every time I have tried to get through to the office it says all people are busy and I am sent to a voicemail. If they could get their phone answering fixed, I would give them a strong 5 stars.read more
MaryAnn Hornbaker
MaryAnn Hornbaker
00:26 25 Feb 21
Dr. Harney is an excellent Dr. I found him friendly , personable and thorough. I evidently am an unusual case. ... Therefore he spent a Hugh amount of time educating me. He even gave me literature to further explain my condition and how to follow up. This is something you rarely get from your doctors. So I am more than please with my doctor and his staff.read more
Roger Arguello
Roger Arguello
03:05 29 Jan 21
Always courteous, professional. The staff is very friendly and always work with you to find the best appointment time.... The care team has been great. Always taking the time to listen to your concerns and to find the best treatment.read more
Margaret Rowland
Margaret Rowland
01:12 27 Jan 21
I have been a patient at Lone Star Neurology for several years. Now both my adult daughters also are patients there. I... love Jodie. She is always so prompt whether it is a teleamed call are a visit in the office. She takes the time to explain everything to me and answers all my questions. I am so blessed to have Jodie as my doctor.read more
Susan Miller
Susan Miller
03:01 13 Jan 21
My husband had an accident 5 years ago and Lone Star Neurology has been such a blessing to us with my husbands care.... Jodie Moore is his provider and she is amazing! Jodie is very knowledgeable, caring, and thorough. She takes her time with you, making sure your needs are met and she is happy to answer any questions you may have. Lone Star Neurology’s patients are very lucky to have Jodie providing their care. Thank you Lone Star Neurology and especially Jodie for everything you have done for us. Jodie, you are the best!read more
Windalyn C
Windalyn C
01:32 09 Jan 21
Jodie is wonderful. She is very caring and knowledgeable. I have been to over a dozen neurologists, and none were able... to help me as much as they have here. Thanks!read more
Katie Kordel
Katie Kordel
00:40 09 Jan 21
Jodi Moore, nurse practitioner, is amazing. I have suffered from frequent, debilitating headaches for almost 20 years.... She has provided the best proactive and responsive care I have ever received. My quality of life has been greatly improved by her caring approach and tenacity in finding solutions.read more
Ellie Natsis
Ellie Natsis
15:41 07 Jan 21
I have had the best experience at this neurologist's office! For over a year I have been receiving iv treatments here... each month and my nurse, Bobbie is beyond wonderful!! She's so attentive, knowledgeable, caring, and detail oriented. She makes an otherwise uncomfortable experience much more pleasant and definitely puts me at ease! She also helps me with my insurance,ordering this specialty medication and dealing with the ordering process which is no easy feat.Needless to say, she goes above a beyond in every way and I'm so grateful to this office and to Bobbie for all they do for me!read more
Matt Morris
Matt Morris
15:39 07 Jan 21
Let me start by saying that I have been coming here for years. Due to my autoimmune disease, I am in this office... once every three weeks for multiple hours at a time. The office is very clean and the staff very friendly. My only complaint would be there communication via phone. They aren't the best at responding if you leave a voicemail and expect a call back. I understand that this is prob just due to the sheer number of alls they receive daily. What I can say I like the best about the office are the people. Bobby who handles my infusions is great. I never have any issues with her setting up my infusions. She is very quick to reply to messages sent via text and if she were to leave then my whole opinion of the office may change. I also enjoy people like Matt, Lauren, and Jodi. I appreciate all that they do for me and without this team I'm not sure I would be as happy as I am to visit the office as frequently as I have to. Please ensure that these folks are recognized as they are what makes my visit to this office so tolerable :).read more
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