What Is Post-Traumatic Epilepsy?

Post-traumatic epilepsy is a condition characterized by regularly occurring seizures after head impact caused by a fall, crash, or knock to the cranium. Penetration of the skull by bullets and other objects can also induce this form of epilepsy. The risk for post-traumatic epilepsy is especially high if the skull is fractured, a severe concussion results or there is intracranial hematoma, which is the pooling of blood within the cranium after a vein or artery ruptures. Victims who experience more than a day of amnesia or unconsciousness due to head injury are also at risk for having post-injury epilepsy.

Doctors continue to research the cause of post-traumatic epilepsy; some studies suggest it is linked to the free radical damage caused by brain injuries. Other studies suggest genetics play a role in who develops recurring seizures after trauma. Since seizures are convulsions caused by damage to brain tissue, any impact that causes depressions in the soft tissues of the brain can create a risk for post-traumatic epilepsy. So, too, can the surgical removal of damaged brain tissue following injury.

Computed tomographic (CT) scans help doctors determine the severity of a brain injury and exactly what physical, biochemical or mechanical alterations have occurred. Often blood flow to the brain is hampered or there are changes in the brain’s metabolism. Equilibrium in the brain can also be damaged by injury, creating stress for the sympathetic or parasympathetic nervous system and putting the victim at risk for post-traumatic epilepsy by skewing brain signals. Doctors can study the brain imaging to determine if post-traumatic seizures are likely and what surgery or treatment should be done.

Seizures resulting from post-traumatic epilepsy may be temporary or permanent. Some victims of brain injury experience immediate seizures, arising within hours and recurring for a few days or weeks. Others, however, may suffer seizures for five years or longer.

Even if seizures do not start immediately, that does not mean the victim has escaped post-traumatic epilepsy. Doctors warn that some individuals with latent post-traumatic epilepsy can go for two to 15 years without symptoms before having their first episode of injury-related seizures. Seizures themselves are unlikely to cause additional brain injury, researchers say.

Halting seizures is possible with medical intervention. In some cases, seizures from post-traumatic epilepsy spontaneously cease on their own. While this form of epilepsy can affect anyone, some demographics have been especially prone, such as construction workers and war veterans who have endured combat brain injuries.