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Posttraumatic Epilepsy

Background

Posttraumatic epilepsy (PTE) is a recurrent seizure disorder that apparently results from injury to the brain.
This injury may be due to multiple types of head insults often labled traumatic brain injury (TBI). There is an increase in PTE due to increasing TBI.

PTE must be differentiated from posttraumatic seizures (PTS), which is a broader-spectrum term and signifies seizures that occur as a sequel to brain injury. Seizures that occur within 24 hours after brain injury are called immediate PTS. PTS that occur within 1 week after injury are termed early PTS, and seizures that occur more than 1 week after injury are termed late PTS. About 20% of people who have a single late posttraumatic seizure never have any further seizures, and these people should not be labeled as having PTE. The former definition of epilepsy required 2 unprovoked seizures, but the updated definition of epilepsy can be met with 1 unprovoked seizure and high likelihood of another. This blurrs the definition of PTS and PTE, but it is important to differentiate between the two. As PTS is a provoked seizure it is different than unprovoked seizure, but late PTS may be hard to differentiate from PTE.

In a patient who had a seizure after a recent head injury, investigation of a seizure should focus on determining whether an intracranial bleed or a change in clinical condition (eg, hyponatremia) has caused the seizure (see Workup). Early PTS should be treated promptly, but treatment for late PTS is not mandatory (see Treatment and Management)

Go to Epilepsy and Seizures for an overview of this topic.

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