Introduction:
Post-traumatic epilepsy is an uncommon condition of recurrent seizure (abnormal electrical activity in the brain) disorder and is believed to be a traumatic brain injury. The most common cause of mortality and morbidity, along with functional disabilities and post-traumatic epilepsies, is usually traumatic brain injury. The guideline for post-traumatic epilepsy recommends a seven-day course of prophylaxis (treatment action taken or given to prevent disease).
Electroencephalography (EEG) and Magnetic Resonance Imaging (MRI) are the tools used to diagnose post-traumatic epilepsy by detecting brain lesions. Antiepileptic drugs are usually used for the treatment of post-traumatic epilepsy. However, antiepileptic drugs are sometimes associated with adverse risk factors.
What Is Epilepsy?
Epilepsy is a neurological disorder in which brain activity becomes abnormal, causes a period of unusual behavior or seizure (abnormal electrical activity in the brain), and causes loss of awareness and sensation. Epilepsy affects both females and males irrespective of age group.
What Are the Symptoms of Epilepsy?
The symptoms of epilepsy are:
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Temporary confusion.
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Uncontrolled movement of legs and arms.
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Loss of awareness or consciousness.
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Psychological symptoms such as anxiety and fear.
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Stiff muscles.
What Is Post-Traumatic Epilepsy?
Post-traumatic epilepsy is a form of acquired epilepsy caused by physical damage to the brain or a recurrent seizure (abnormal electrical activity in the brain) disorder that results from brain injury. About one in fifty people with brain injury are likely to develop post-traumatic epilepsy. Developing post-traumatic epilepsy is more common in children than adults.
What Are the Causes of Post Traumatic Epilepsy?
The causes of post-traumatic epilepsy are :
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Genetics: Plays a role in the risk of developing post-traumatic epilepsy.
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The Severity of Trauma: If the trauma is severe, the chances of having post-traumatic epilepsy are higher.
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Nature of Trauma: Influences post-traumatic epilepsy. People with penetrating head trauma, depressed skull fractures, and subdural hematoma (refers to the pool of blood between the brain and its outermost covering) due to traumatic brain injury.
What Are the Symptoms of Post Traumatic Epilepsy?
The various symptoms of post-traumatic epilepsy are:
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Lip-smacking, chewing, and fumbling movements.
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Dizziness or sudden tiredness.
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Changes in the sense of hearing, smell, or taste.
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Vision changes.
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Not able to speak or understand others.
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Extreme fatigue.
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Loss of sleep.
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Drug and alcohol use.
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Chemical changes in the body include low magnesium, sodium, or high calcium.
What Are the Clinical Features of Post Traumatic Epilepsy?
The clinical features of post-traumatic epilepsy are :
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The prevalence of incidence of post-traumatic epilepsy is more in males as compared to females.
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It most commonly affects 0 to 12 years and 15 to 27.
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Generalized onset seizure is the most common type of seizure.
What Are Different Types of Post Traumatic Epilepsy?
The different types of post-traumatic epilepsy are as follows:
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Immediate Post-Traumatic Epilepsy: A seizure that occurs within 24 hours after injury to the brain is called immediate post-traumatic epilepsy.
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Early Post Traumatic Epilepsy: Seizure that occurs within one week after injury to the brain.
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Late Post-Traumatic Epilepsy: A seizure that occurs after more than one week is called late post-traumatic epilepsy.
What Are the Risk Factors of Post Traumatic Epilepsy?
The various risk factors associated with post-traumatic epilepsy are as follows:
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Skull fracture.
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History of alcohol abuse.
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Severe traumatic brain injury.
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Retained intracerebral fragments.
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Penetrating injury.
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Epidural hemorrhage (collection of blood that forms between dura mater and skull).
How to Diagnose Post-Traumatic Epilepsy?
The person should have encountered a head injury to diagnose post-traumatic injuries. The following methods are used for the diagnosis of post-traumatic epilepsy :
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Electroencephalography (EEG): It is used for the diagnosis of seizure disorder. It can be helpful to determine severity, localize epileptic focus and predict the recurrence of epilepsy if the epileptic drug consumption is stopped.
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Magnetic Resonance Imagining (MRI): It is performed to detect the presence of post-traumatic epilepsy.
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Computed Tomography (CT) Scan: It is used if magnetic resonance imaging (MRI) is not available to detect any lesion formation in the brain.
What Is Management for Post-Traumatic Epilepsy?
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Early post-traumatic epilepsy should be treated as it can proceed and damage brain activity and already compromised brain.
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In case of active seizures, antiepileptic drugs such as Sodium Valproate are. They can be used with intravenous (IV) Benzodiazepine for their effectiveness.
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In the case of late post-traumatic epilepsy, treatment is not necessary. However, some patients choose not to take regular medicine as compliance with long-term treatment is often very poor.
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Patients with post-traumatic epilepsy should be on medication, and surgical treatment is also an option for post-traumatic epilepsy refractory to medicine.
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Things to be kept in mind if the seizure has not stopped are to avoid climbing on a ladder, roof, or tree. Always accompany someone going to the swimming pool or beach.
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Loosen the tight clothes of the affected person, especially around the neck region.
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Make sure the person should avoid falling accidentally.
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The person should be turned on the side so that anything in the mouth does not block the throat.
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In some situations often, cardiopulmonary resuscitation (CPR) is performed.
What Are Lifestyle Modifications for Post-Traumatic Epileptic Patients?
The various lifestyle modifications for post-traumatic epileptic patients are :
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Diet: It is important for the treatment of refractory treatment in children.
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Sleep: Lack of sleep can trigger an epileptic attack. Proper sleep habits should be practiced with care.
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Exercise: It is essential to reduce the risk of post-traumatic epilepsy.
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Caffeine, Drugs, and Alcohol: Tend to trigger a non-traumatic seizure.
Conclusion:
Post-traumatic epilepsy is a network of consequences of traumatic brain injury. It is often classified as a chronic seizure condition after any brain injury. People who experience traumatic brain injury have a high risk of developing seizures and epilepsy. Post-traumatic epilepsy can be a complex and large problem that should never be ignored. Post-traumatic epilepsy can be caused by various biomechanical processes that occur in the brain after any trauma. The prognosis of post-traumatic epilepsy is considered the worst. Almost 80 % of patients with post-traumatic epilepsy experience seizures within the initial two years of their injury, and the risk is reduced after five years of trauma or injury experienced.
