Head trauma and seizures

Selected patients with a history of head trauma may have isolated or recurrent seizure activity. Seizures may occur in the setting of an acute traumatic brain injury, i.e., post-traumatic seizures, or 1 week or longer from the head trauma, i.e., post-traumatic epilepsy (PTE). Several clinical risk factors may be associated with an increased risk of PTE including severe head trauma with dural penetration, intracerebral hemorrhage, and need for operative intervention; combat or military-related traumatic brain injuries; and acute post-traumatic seizures. The prophylactic use of antiseizure drugs (ASDs) is controversial. ASD may reduce the presence of early post-traumatic seizures, but are not effective prophylactically in preventing PTE. Ultimately, the care and management of the patient with traumatic brain injury and seizures is to render the patient seizure-free and minimize the adverse effects of therapy.