Abstract
Background: Traumatic brain injury (TBI) is one of the most leading causes of deaths and disability among youth worldwide. Post-traumatic seizures (PTS) and post-traumatic epilepsy (PTE) are important catastrophic complications of TBI. Epilepsy has important medico-legal aspects for both the patient and the physician. Aim of the study: to identify forms of post traumatic seizures (generalized, focal, or focal followed by secondary generalized), site of epileptic focus, nature of brain injury that caused their occurrence, risk factors for epilepsy occurrence and medico-legal importance of PTS. Methods: A prospective cross-sectional study was conducted including patients with PTS and PTE who presented to El Demerdash and Ain shams Specialized Hospitals during the study period. Data were collected from patients by a questionnaire and from clinical sheets. Patients were classified into three groups according to time of occurrence of PTS. Results: A total of 77 patients were included. Cases were mostly in the age group less than 45 years old. Male patients were more represented in the study (64.9%). Transportation injuries were the most prominent pattern of TBI followed by blunt trauma (29.9%), open head injuries (13%), fall from height (13%) and polytrauma (1.3%). The most common affected site was frontal area of the brain (51.9%) followed by temporal region (45.5%). Associated complications included intra-cranial hemorrhage (87%) and skull fracture (35.1%). Immediate seizures were recorded in 9.1 % of the studied patients compared to 26% with early PTS. Patients with late PTS were the majority accounting for 64.9% of study patients of whom 50% with late PTS from the start. Most cases experienced generalized seizures attacks (59.7%) followed by focal with secondary generalization seizures attacks in (27.3%) and the least were with focal seizures attacks (13.0%). EEG showed abnormal activity in (62.3%) of patients and normal activity in (37.7%). Conclusion: Post-traumatic seizures and epilepsy are an important well-known sequel of traumatic brain injury with important medico-legal aspects. Pattern of head injury and site of traumatic area are important risk factors in occurrence of PTS and EEG abnormal activity is an important predictor for occurrence of PTS as well.
Highlights
Traumatic brain injury (TBI)is known to be one of the most common and important causes of acquired epilepsy
Post-traumatic seizures can be classified according to the time of occurrence after trauma as; immediate post-traumatic seizures that occur within 24 hours from injury, early seizures that occur in the first week of trauma and late PTS that occur after more than week (Frey, 2003)
Our results suggest that transportation injuries are strongly related to occurrence of immediate post-traumatic seizures
Summary
Traumatic brain injury (TBI)is known to be one of the most common and important causes of acquired epilepsy. Posttraumatic epilepsy (PTE) is defined as recurrent spontaneous seizures following traumatic brain injury, even if the patient experienced one unprovoked seizure after PTS (Thapa et al, 2010). Post-traumatic seizures (PTS) and post-traumatic epilepsy (PTE) are important catastrophic complications of TBI. Aim of the study: to identify forms of post traumatic seizures (generalized, focal, or focal followed by secondary generalized), site of epileptic focus, nature of brain injury that caused their occurrence, risk factors for epilepsy occurrence and medico-legal importance of PTS. Conclusion: Post-traumatic seizures and epilepsy are an important well-known sequel of traumatic brain injury with important medico-legal aspects. Pattern of head injury and site of traumatic area are important risk factors in occurrence of PTS and EEG abnormal activity is an important predictor for occurrence of PTS as well
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More From: Ain Shams Journal of Forensic Medicine and Clinical Toxicology
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