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Chapter 2 - Post-traumatic Epilepsy: Epidemiology, Definition and Terminology

Published online by Cambridge University Press:  10 August 2021

By
Peter Jenkins  and
Hannah Cock
Edited by
Marco Mula
Marco Mula
Affiliation:
St George's Hospital Medical School, University of London
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Summary

Traumatic brain injury (TBI) is a major risk factor for the development of epilepsy, accounting for around 5% of all epilepsy cases. The risk is greatest within the first year of injury but persists for many years afterwards. Severity of injury is the biggest predictor of future risk of epilepsy, with evidence of intracerebral and sub-dural haemorrhage being important clinical indicators. Individual characteristics including medical co-morbidities and genetic predisposition also influence this risk.

TBI-related seizures are separated into those arising within the first week of injury (early post-traumatic seizures) and those happening later (late post-traumatic seizures). This distinction is useful because early post-traumatic seizures do not appear to be an independent risk factor for the future development of epilepsy. However, the risk of further seizures after a single late post-traumatic seizure is as high as 80%. Therefore, one late post-traumatic seizure signals an increased predisposition to generate future epileptic seizures. This fulfils the criteria for diagnosing epilepsy and the individual should be counselled and treated accordingly.

In this chapter, we discuss the classification of epilepsy and TBI severity before summarising the largest epidemiological studies that have attempted to ascertain the incidence and prevalence of post-traumatic epilepsy and the major risk factors.

Keywords

Traumatic brain injuryepilepsyseizurespost-traumatic epilepsy
Type
Chapter
Information
Post-traumatic Epilepsy , pp. 29 - 46
Publisher: Cambridge University Press
Print publication year: 2021

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