Post-Traumatic Seizures: A Deep-Dive Into Pathogenesis

Anwer, Fatima; Oliveri, Federico; Fotios, Kakargias; Panday, Priyanka; Franchini, Ana P Arcia; Iskander, Beshoy; Hamid, Pousette

doi:10.7759/cureus.14395

Cited by 6 publications

(11 citation statements)

References 30 publications

(44 reference statements)

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“…Seizures that occur immediately (within 24 h of trauma) are not considered "epileptic" and are attributed to the impact itself (Agrawal et al, 2006). Epilepsy developing after an acute brain insult is referred to as post-traumatic epilepsy (PTE) (Verellen and Cavazos, 2010;Anwer et al, 2021). In evaluating any patient presenting with a seizure of unclear etiology, history of head injury is crucial information.…”

Section: Tbi and Seizuresmentioning

confidence: 99%

Traumatic brain injury: Mechanisms, manifestations, and visual sequelae

et al. 2023

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Traumatic brain injury (TBI) results when external physical forces impact the head with sufficient intensity to cause damage to the brain. TBI can be mild, moderate, or severe and may have long-term consequences including visual difficulties, cognitive deficits, headache, pain, sleep disturbances, and post-traumatic epilepsy. Disruption of the normal functioning of the brain leads to a cascade of effects with molecular and anatomical changes, persistent neuronal hyperexcitation, neuroinflammation, and neuronal loss. Destructive processes that occur at the cellular and molecular level lead to inflammation, oxidative stress, calcium dysregulation, and apoptosis. Vascular damage, ischemia and loss of blood brain barrier integrity contribute to destruction of brain tissue. This review focuses on the cellular damage incited during TBI and the frequently life-altering lasting effects of this destruction on vision, cognition, balance, and sleep. The wide range of visual complaints associated with TBI are addressed and repair processes where there is potential for intervention and neuronal preservation are highlighted.

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Section: Tbi and Seizuresmentioning

confidence: 99%

Traumatic brain injury: Mechanisms, manifestations, and visual sequelae

et al. 2023

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“…4 Risiko epilepsi pasca-trauma kapitis bervariasi tergantung lokasi benturan dan tingkat keparahan cedera. 5,6 Kebanyakan pasien epilepsi pasca-trauma kapitis menderita cedera kepala sedang hingga berat, termasuk cedera kranioserebral tunggal atau ganda. 7 Insiden kumulatif bangkitan terlambat (late seizure) lebih dari 30 tahun setelah cedera kapitis adalah 2% untuk cedera ringan, 4% untuk cedera sedang, dan lebih dari 15% untuk cedera berat.…”

Section: Pendahuluanunclassified

“…4 Risiko munculnya epilepsi pascatrauma kapitis bervariasi tergantung lokasi benturan dan tingkat keparahan cedera. 5,6 KLASIFIKASI Bangkitan pasca-trauma kapitis diklasifikasikan berdasarkan onset setelah cedera, yaitu immediate, early seizures, dan late seizures. Bangkitan pasca-trauma kapitis immediate bersifat segera yang terjadi dalam kurun waktu 24 jam.…”

Section: Pendahuluanunclassified

Tinjauan atas Epilepsi Pasca-Trauma Kapitis

Wangidjaja¹,

Wreksoatmodjo²

2022

Cermin Dunia Kedokteran

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Epilepsi pasca-trauma kapitis merupakan salah satu disabilitas akibat cedera kepala; yaitu bangkitan epileptik yang terjadi setelah 7 hari sampai bertahun-tahun pasca-trauma kapitis. Epilepsi pasca-trauma kapitis lebih sering ditemukan pada laki-laki, terutama di kelompok usia 0-12 tahun dan 15-27 tahun. Beberapa mekanisme perubahan aktivitas otak yang memicu bangkitan setelah cedera kepala, antara lain peningkatan penanda inflamasi dan sitokin serta perubahan sawar darah-otak; perubahan tersebut berperan penting dalam patogenesis kejang pasca-trauma. Pengobatan anti-konvulsan (OAE) jangka panjang direkomendasikan untuk pasien epilepsi pasca-trauma kapitis. Tingkat remisi epilepsi pasca-trauma kapitis adalah sekitar 25% - 40% dengan pengobatan awal yang dilakukan. Post-traumatic epilepsy, one of the disabilities due to head injury, is epileptic seizures that occur after 7 days to years after head injury. It is more common in males and peaks in the 0-12 year and 15-27 year age groups. Several mechanisms may trigger changes in brain activity after head injury; including increased inflammatory markers and cytokines, and changes in the blood-brain barrier; those changes may play an important role in the pathogenesis of posttraumatic seizures. Long-term anticonvulsant treatment (OAE) is recommended for patients with posttraumatic epilepsy. The remission rate of post-traumatic epilepsy is 25%-40% with early initial treatment.

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“…These are different from acute episodes (< 1 week), which are mostly triggered. The PTE can lead to a detrimental effect on the quality of life" [9,10,16].…”

Section: Introductionmentioning

confidence: 99%

“…"Approximately 80% of TBI patients who eventually develop epilepsy will receive a PTE diagnosis within 2 years after the TBI. Multiple mechanisms have been explained in the past that led to altered brain activity provoking seizures, including increased inflammatory markers, neuronal cell death, altered blood-brain barrier, changes in astrocytes, and glucose metabolism dysregulation changes in synaptic abundance and function, and just to name a few, have been studied for their role in PTE" [8,[16][17][18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

Post Traumatic Epilepsy with Sequel of Frontal Contusion and Spontaneous Regression of Extradural Hematoma; Clinical Case and Review of the Literature

Fondop

Foagouo²,

Fred

et al. 2022

INDJ

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Post traumatic epilepsy are frequent complications of moderate and severe head injuries, they are found in hemorrhagic contusions and hematomas. Several isolated or associated mechanisms are involved in the occurrence of these convulsions (increased inflammatory markers, neuronal cell death, altered blood-brain barrier, changes in astrocytes, and glucose metabolism dysregulation changes in synaptic abundance and function).The first attacks can occur more than 2 years after the head trauma or after cranial surgery. Preventive treatment does not change the course of the disease. Treatment with Valproate and levetiracetam were also compared to phenytoin and no benefit was found in recovery. The particularity of our patient is the severe head trauma, with regressive frontal contusion with secular lesions, followed by the appearance at nearly three and a half months of the trauma of a fronto-parietal extradural hematoma with mass effect which resolved spontaneously. Two and three years after the trauma, he developed generalized epilepsy, suggesting post-traumatic epilepsy following the sequelae of the hemorrhagic contusion or the extradural hematoma, or the sequelae of these associated lesions. These seizures were treated with sodium valproate. This clinical case challenges clinicians to monitor in severe head injuries the occurrence of complications such as epilepsy that can occur beyond 2 years.

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Post-Traumatic Seizures: A Deep-Dive Into Pathogenesis

Cited by 6 publications

References 30 publications

Traumatic brain injury: Mechanisms, manifestations, and visual sequelae

Traumatic brain injury: Mechanisms, manifestations, and visual sequelae

Tinjauan atas Epilepsi Pasca-Trauma Kapitis

Post Traumatic Epilepsy with Sequel of Frontal Contusion and Spontaneous Regression of Extradural Hematoma; Clinical Case and Review of the Literature

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