What is Post-Traumatic Epilepsy?

Post-traumatic epilepsy is a well-recognised complication of brain injury. Epilepsy is a disruption of brain function that results in seizures or fits. Post-traumatic epilepsy can be classified into two groups based on the time of occurrence in relation to your brain injury. EARLY seizures are those which occur within one week of injury. LATE seizures are seizures which occur after the first week. The term epilepsy implies recurrence, hence post-traumatic epilepsy tends to refer to late recurrent seizures.

Does Everyone With a Brain Injury Get Post-Traumatic Epilepsy?

No - however, there are factors associated with brain injuries that increase the likelihood of a person having seizures.

What Are These Risk Factors?

The incidence of Post-Traumatic Epilepsy is in most cases, related to the severity of the injury. Risk factors include:

• Early seizures
• Intracranial haematoma
• Open head Injury
• Depressed skull fracture
• CT scans showing an intracerebral bleed
• Prolonged duration of coma and post traumatic amnesia

What Causes Post-Traumatic Epilepsy?

Scarring of the brain tissue can become a focus for a seizure which is an abnormal electrical activity in the brain.

How Do I Know a Seizure When I See One?

There are two main types of seizures that can occur after brain injury:

• Focal Seizures: These may involve jerking/twitching of a body part
• Generalised (tonic-clonic) seizures: These can be recognised by sudden loss of consciousness, body stiffening followed by general body jerking.

The person may appear confused after either focal or generalised seizures. Most post-traumatic seizures are focal seizures and a large percentage of these can progress on to generalised seizures.

Rarely, a brief 'absence' is also a seizure type that can occur after brain injury.

What Should I do if Someone is Having a Seizure?

• Stay calm
• Time the seizure
• Do not try to restrain the person
• Do not put anything in the mouth
• Do not apply mouth to mouth
• Protect the person from injury
• Clear the area of harmful objects
• Loosen their tie or collar
• Place something soft under their head and shoulders
• As soon as possible, roll the person onto their side to keep their airway clear
• Stay with and reassure the person until they have fully recovered

Call an ambulance if:

• Active or jerking movements of the seizure last for more than 5 minutes
• Another seizure quickly follows
• The person has been injured
• You are in doubt as to whether the person is okay

Do I Have to Take Medication for the Rest of my Life?

The risk of developing post-traumatic epilepsy in the first two years is high, however the risk of developing post-traumatic epilepsy also decreases with length of time following injury, hence a decision to start or continue anti-epileptic medication will be made by your doctor based on your potential risk factors as well as your progress since the injury. People are occasionally maintained on anti-epileptic drugs for six months or up to two years. Stopping of medication should be supervised by your doctor and then tapered off over at least six weeks.

What Kinds of Activities Should be Avoided?

If you have had a seizure, or your risk is high, there will probably be a restriction on your driving or operating machinery. Your should discuss these restrictions with your doctor.

What Can I do to Help?

Lifestyle management has a definite role in helping people maintain good seizure prevention and control. Tiredness, lack of sleep, emotional stress, alcohol and illicit drugs can all trigger seizures. It is also important to keep taking tablets prescribed for post-traumatic epilepsy and if there are any concerns regarding the medication, side-effects or seizures, then you should talk to your doctor.

Aim to:

• Get plenty of sleep
• Drink no alcohol while on medication for epilepsy
• Do not use marijuana, speed or other illicit drugs

Last modified: Thursday, 20 April 2006