Seizures After Traumatic Brain Injury

When someone hurts their head really badly, sometimes they can have seizures afterward. Seizures are like sudden bursts of electricity in the brain that make the body do strange things. This can happen after a traumatic brain injury, which is when the brain gets hurt. In fact, about one in every three people who are hospitalized because of a traumatic brain injury will have seizures afterward. Let’s understand more about seizures that happen after someone has had a traumatic brain injury.

Understanding Traumatic Brain Injury (TBI)

Causes of TBI

Traumatic Brain Injury, or TBI, happens when someone gets a really hard hit to the head. This can happen in lots of different ways, like during a car accident, if someone falls and hits their head, or if they get hurt while playing sports. Sometimes, things like explosions or being hit by something really hard can also cause TBI. Basically, anything that causes a big bang or a strong hit to the head can cause TBI.

Types of TBI

Closed head injury

This is when someone gets a hit to the head, but their skull doesn’t break. Even though the skull doesn’t break, the brain can still get hurt because it bangs against the skull. This can cause swelling and bleeding inside the brain, which can be really serious.

Penetrating head injury

This is when something goes through the skull and hurts the brain directly. This can happen if someone gets shot in the head or if something sharp, like a knife or a piece of metal, goes into the skull. Penetrating head injuries are usually very serious and can cause a lot of damage to the brain.

Immediate and long-term effects of TBI

When someone gets a TBI, they can have all sorts of immediate effects, like headaches, dizziness, confusion, and even passing out. Sometimes, these effects go away after a while, but other times, they can last for a long time or even be permanent.

In the long term, TBI can cause all sorts of problems, like trouble with thinking, memory, and concentration. It can also cause mood swings, depression, and anxiety. Some people with TBI have trouble with things like walking, talking, and taking care of themselves. These long-term effects can be really hard to deal with, and some people need a lot of help to get better.

Post-Traumatic Epilepsy (PTE)

What is PTE?

Post-Traumatic Epilepsy, or PTE, is when someone starts having seizures after they’ve had a traumatic brain injury, or TBI. Seizures are like sudden bursts of electricity in the brain that make the body do strange things. They can cause someone to shake a lot, fall down, or lose consciousness. PTE can happen soon after the brain injury, or it can happen weeks, months, or even years later. It’s different for everyone.

Risk factors for developing PTE

Some people who have a traumatic brain injury are more likely to develop PTE than others. Certain things can increase the risk of developing PTE, like how severe the injury was, where in the brain the injury happened, and how old the person is. People who have had a penetrating head injury, where something goes through the skull and hurts the brain directly, are more likely to develop PTE than people who have had a closed head injury, where the skull doesn’t break.

Timeline for developing PTE

PTE can happen at any time after a traumatic brain injury. For some people, it can happen right away, while they’re still in the hospital recovering from their injury. For others, it can happen weeks, months, or even years later. There’s no set timeline for when PTE might develop, so it’s important for people who have had a traumatic brain injury to be aware of the signs of seizures and to talk to their doctor if they have any concerns.

Types of Seizures After Traumatic Brain Injury

When someone has a seizure after a traumatic brain injury, there are different types it can be. Here are two main types:

Focal (Partial) seizures

These seizures happen when the abnormal electrical activity in the brain is focused in one specific part of the brain. There are two types of focal seizures:

Simple focal seizures

In these seizures, the person stays awake and aware during the seizure. They might feel strange sensations or twitching in one part of their body, like their arm or their leg.

Complex focal seizures

These seizures can make a person feel confused or dazed. They might not be aware of what’s happening around them, and they might do things like stare blankly into space or make repetitive movements, like rubbing their hands together.

Generalized seizures

These seizures happen when the abnormal electrical activity in the brain affects both sides of the brain at the same time. There are different types of generalized seizures:

Tonic-clonic seizures

These seizures used to be called grand mal seizures. During a tonic-clonic seizure, the person loses consciousness and their muscles stiffen and jerk uncontrollably. They might also lose control of their bladder or bowels and bite their tongue or cheek.

Absence seizures

These seizures used to be called petit mal seizures. During an absence seizure, the person briefly loses consciousness and stares blankly into space. They might also make repetitive movements, like blinking or smacking their lips.

Atonic seizures

During an atonic seizure, also called a drop attack, the person’s muscles suddenly go limp, causing them to collapse or fall down.

Symptoms of Seizures After TBI

1. Physical symptoms

Seizures can cause all sorts of physical symptoms, like:

• Shaking or jerking movements in one part of the body or in the whole body
• Stiffening of the muscles
• Falling down suddenly
• Loss of consciousness, where the person is not aware of what’s happening around them
• Breathing problems
• Loss of control of bladder or bowel

2. Emotional and cognitive symptoms

Seizures can also cause emotional and cognitive symptoms, like:

• Confusion or disorientation
• Feeling scared or anxious
• Feeling tired or sleepy
• Memory problems
• Trouble speaking or understanding language
• Changes in mood or behavior, like feeling angry or irritable

These symptoms can be really scary and confusing, but it’s important to remember that seizures are not usually dangerous and they usually go away on their own after a short time. If someone has a seizure, it’s important to stay calm, keep them safe, and call for help if needed.

Diagnosing Seizures After TBI

Medical history and physical examination

First, the doctor will ask the person about their medical history and any symptoms they’ve been having. They’ll also do a physical examination to check for things like muscle weakness, problems with coordination, or changes in behavior.

Neurological examination

Next, the doctor will do a neurological examination to check how well the person’s brain and nervous system are working. They’ll look for things like abnormal movements, changes in reflexes, or problems with balance and coordination.

Electroencephalogram (EEG)

An EEG is a test that measures the electrical activity in the brain. During an EEG, small electrodes are placed on the person’s scalp, and the electrical signals from their brain are recorded. This can help the doctor see if there are any abnormal patterns of electrical activity in the brain that might be causing the seizures.

MRI or CT scans

MRI and CT scans are imaging tests that can show detailed pictures of the brain. These tests can help the doctor see if there are any problems in the brain, like swelling, bleeding, or scar tissue, that might be causing the seizures.

It’s like taking a picture of the inside of the person’s brain to see if everything is working the way it’s supposed to.

By using these tests, doctors can figure out what’s causing the seizures and come up with a treatment plan to help the person feel better.

Treatment Options for Seizures After TBI

When someone has seizures after a traumatic brain injury, there are different treatments that can help them feel better. Here are some of the main options:

Medications

One common treatment for seizures after TBI is medication. The most common type of medication used to treat seizures is called antiepileptic drugs, or AEDs for short. These medications work by calming down the abnormal electrical activity in the brain that causes seizures. There are many different AEDs available, and the doctor will work with the person to find the one that works best for them. It’s like giving the brain a little bit of medicine to help it stay calm and stop having seizures.

Surgery

In some cases, surgery might be an option for treating seizures after TBI. During surgery, the doctor can remove the part of the brain that’s causing the seizures, or they can place a small device in the brain that helps to control the electrical activity and prevent seizures. Surgery is usually only considered if other treatments haven’t worked and the seizures are really severe.

Vagus nerve stimulation (VNS)

Vagus nerve stimulation is another treatment option for seizures after TBI. During VNS, a small device called a stimulator is placed under the skin in the chest. The stimulator is connected to the vagus nerve, which runs from the brain to the body. The stimulator sends small electrical pulses to the brain, which can help to prevent seizures.

Ketogenic diet

Some people with seizures after TBI might benefit from following a special diet called the ketogenic diet. The ketogenic diet is high in fat and low in carbohydrates, and it can help to reduce the frequency and severity of seizures in some people. It’s not entirely clear how the ketogenic diet works to prevent seizures, but it may help to change the way the brain uses energy.

These are just a few of the treatment options available for seizures after TBI. The best treatment for each person depends on things like how severe their seizures are, what other health problems they have, and how they respond to different treatments. It’s important for people with seizures after TBI to work closely with their doctor to find the treatment that works best for them.

Preventing Seizures After TBI

Immediate treatment of TBI

Getting prompt and proper treatment for a traumatic brain injury is really important for preventing seizures later on. This includes things like:

• Getting medical help right away if someone hits their head really hard
• Going to the hospital to get checked out by a doctor
• Following the doctor’s instructions for treating the brain injury, like taking medications, resting, and avoiding activities that could make the injury worse

Monitoring and managing brain injuries

After someone has had a traumatic brain injury, it’s important for them to be monitored closely by their doctor to make sure everything is okay. This might include things like:

• Getting regular check-ups with the doctor
• Having regular tests, like MRI or CT scans, to check for any changes in the brain
• Following up with a neurologist or other specialist if needed

Compliance with medications and treatment plans

Taking medications as prescribed and following the doctor’s treatment plan is really important for preventing seizures after TBI. This includes things like:

• Taking antiepileptic drugs (AEDs) exactly as prescribed
• Going to all scheduled doctor’s appointments
• Following any other instructions from the doctor, like following a special diet or getting enough rest