Why does tbi cause seizures

Seizures which occur in the late period after TBI are more likely to recur and result in epilepsy. Seizures which occur more than a week after a traumatic brain injury are considered late seizures. Most often when this happens, it is because there has been more serious injury to brain cells and the chemical environment around the cells has also changed.

Late seizures are more likely to lead to the complication of post-traumatic epilepsy. A person with post-traumatic epilepsy PTE is someone with risk for recurrent seizures as a result of a brain injury.

About 1 in 50 people who have traumatic brain injuries will go on to develop PTE. There is a spectrum of severity of PTE that ranges from well controlled seizures to disabling seizures that are resistant to treatment. Most seizures 8 out of 10 people in post-traumatic epilepsy are focal and may spread to become bilateral tonic clonic seizures.

This means that they start in one area of the brain focal but spread to involve the entire brain generalized. Sometimes the beginning of these seizures focal onset can be determined and relates to the area of the brain injured, other times it is harder to determine where a seizure begins.

A person may have focal aware or focal impaired awareness seizures but these are less frequent occur in about 2 out of 10 people. In 1 out of 2 people post traumatic epilepsy occurs within one year of their brain injury. The more severe the head injury the longer a person is at risk for developing epilepsy.

Risk for PTE developing decreases substantially with time but can extend out to 15 years after the original traumatic injury for people with the most severe brain injuries. When there is a traumatic blow to the head, or a jarring or shaking of the brain, the impact of the brain against the rough edges on the inside of the skull can cause tearing of the coverings of the brain, tissues, and blood vessels that may cause bleeding.

The impact can also cause bruising contusion and swelling edema of the brain. Since the brain is covered by the skull, there is only a small amount of room for it to swell. This causes pressure inside the skull to increase, which can lead to additional widespread brain injury. The brain does have some areas which when injured are more likely to result in recurrent seizures.

Areas of the brain which are frequently involved include the temporal lobe, and the frontal and occipital lobes. We are all familiar with this type of seizure which generally results in violent shaking of the arms, legs, head and neck. But, it is important to understand that there are individuals who sustain generalized seizures and never have any convulsions. These individuals may just appear to be staring off into space and be dazed. They are disconnected from everything around them and are unaware of what is going on for that period of time.

In partial seizures only a small part of the brain is affected. The seizure or electrical activity remains confined to one area of the brain and does not spread to other areas. The person may be conscious or unconscious during the seizure. Frequently partial seizures do not involve convulsions. All that the individual may experience is an altered sense of taste or smell, a feeling of fear or uncontrollable outbursts of crying.

It can also involve waking up from a sound sleep on a regular basis, bed wetting, sleep walking, or even a sensation of numbness, tingling, or the sound of strange noises or voices. It is important that you consult with a trained neurologist who specializes in seizure disorders.

These doctors are frequently associated with hospital epilepsy centers. A negative EEG does not mean that an individual does not have a seizure disorder. Not all epilepsy can be diagnosed by using EEG monitoring. While this device measures the electrical activity of the brain, the test must take place during the time that the nerves in the brain are misfiring.

Frequently, the results of the EEG are normal even though the person actually has epilepsy. In order to make a diagnosis, a trained epilepsy specialist must resort to careful and detailed questioning of the individual suspected of having epilepsy, as well as their family and close friends. Other times, a person may be hospitalized and monitored continuously using video EEG equipment over several days to attempt to capture a seizure on tape.

We are leading advocates in the United States for survivors of traumatic brain injury including traumatic epilepsy and traumatically induced seizure disorder. Although most people with a TBI will never have a seizure, 1 out of 10 people who were hospitalized after a TBI will have seizures. Most seizures happen in the first few days or weeks after a TBI. But some may occur months or even years after the injury. In rare cases, seizures can make it harder for a person with a TBI to function because of new difficulties with thinking or moving.

A seizure is sudden and abnormal electrical activity in the brain. During a seizure, one or more of the following symptoms may occur:. Seizures usually last a few seconds or minutes but can last for 5 to 10 minutes. During a seizure, you may have a bladder or bowel accident; you may bite your tongue or the inside of your mouth.

After a seizure, you may feel drowsy, weak, or confused or have a hard time talking to or understanding others. After a severe seizure, which lasts longer than 2 minutes, it may be hard for you to stand, walk, or take care of yourself for a few days or even longer.

Medicines used to control seizures are called antiepileptic drugs AEDs. AEDs may be used for other problems, such as chronic pain, restlessness, or mood instability. You and your doctor will decide which drug to use based on the type of seizures you have, your age, how healthy you are, and if you have side effects from the medicine. Although AEDs rarely cause birth defects in newborns, you should tell your doctor if you are pregnant or may become pregnant.

Sometimes your doctor will prescribe two or more AEDs to stop your seizures. Some common AEDs are listed below. Anti-seizure medicines usually work. If you still have seizures after trying medicine, your doctor may send you to a comprehensive epilepsy center.

At the center, you will see special seizure doctors called epileptologists or neurologists who specialize in epilepsy. This information may help your doctor decide what medicine will work best.

It may also help the doctor figure out if other types of treatment will help with the seizures you are having. To find a center near you, you can visit the websites of the Epilepsy Foundation www. The laws vary from state to state. Family members and caregivers should watch closely during a seizure so they can describe what happened to your doctor and other health care providers.

They should make a diary with the date, time of day, length of time, and a description of each seizure. Your doctor will need this information, along with the medicines you are taking to control your seizures. The role of antiseizure prophylaxis following head injury. In: Management and prognosis of severe traumatic brain injury pp. Englander, J. Bergman, W. Analyzing risk factors for late posttraumatic seizures: A prospective, multicenter investigation.

Archives of Physical Medicine and Rehabilitation, 84 3 , — Gupta, P. Diaz-Arrastia, R. Subtypes of post-traumatic epilepsy: Clinical, electrophysiologic, and imaging features. Journal of Neurotrauma , 31 16 ,— Yablon, S.