2003 issue 2

Back

Volume 12, issue 2

Review article

Posttraumatic epilepsy

Agnieszka Machowska-Majchrzak1, Krystyna Pierzchała1
1. Katedry i Kliniki Śląskiej Akademii Medycznej w Zabrzu
Postępy Psychiatrii i Neurologii, 2003, 12 (2), 217-222
Keywords: epilepsy, head trauma, posttraumatic epilepsy, risk factors

Abstract

Aim – to present a review of the literature on posttraumatic epilepsy, one of the major complications after cranio-cerebral trauma.

Review – The overall risk of late posttraumatic epilepsy varies from 2% to 23% and clearly depends on head trauma severity. The time interval between trauma and posttraumatic seizures is of various length. Over 50% of late seizures occur within one year of injury, 70-80% within two years. According to many authors, significant risk factors are: loss of consciousness or posttraumatic amnesia of over 24 hours duration, focal signs in the neurological examination and shown in CT, especially in cases of frontal lesions and damage to paraventricular-subcortical structures, intracranial hematoma and diffuse contusion, depressed skull fracture, penetrating injury, or of early posttraumatic seizures. Despite a poor prognostic value of EEG, the presence of paroxysmal activity is a risk factor. In view of the high prevalence rates of posttraumatic epilepsy the issue of preventive treatment is widely disputed.

Conclusions – Current research findings suggest that anti-epileptic treatment should be provided if an early posttraumatic seizure is reported. Moreover, irrespectively of the seizure onset, anti-epileptic drugs should be administered to patients at high risk for posttraumatic epilepsy.

Address for correspondence:
Dr Agnieszka Machowska-Majchrzak, Klinika Neurologii Śląskiej Akademii Medycznej,
ul. 3 Maja 13/15, 41-800 Zabrze, tel./fax: (32) 2710975, e-mail: majfam@ka.onet.pl