Epilepsy Talk

Traumatic Brain Injury and Epilepsy | April 13, 2014

In a fraction of a second, head trauma can dramatically change a person’s life.

Head trauma caused by falls, physical abuse, violence, vehicle crashes and sporting accidents, not to mention modern warfare.

However, it’s important to realize that not all head injuries, even severe ones, result in seizures. And seizures frequently occur in people who haven’t experienced head trauma.

But close associations do exist between head trauma and seizures — as much as twelve times as opposed to someone without a head trauma.

The difficulty of a diagnosis is that epilepsy does not typically develop immediately after head trauma.

Studies suggest that approximately 6% of patients with epilepsy have TBI as the cause. It generally depends upon how severe the head trauma is.

Immediate or Mild Seizures:
They may develop immediately after the accident. The person is awake with eyes open. Symptoms can include confusion, disorientation, memory loss, headache, and a brief loss of consciousness.

Early Onset or Moderate Seizures:
Will usually develop with the first 24 hour hours. Loss of consciousness lasting 20 minutes to 6 hours may occur, as well as some brain swelling or bleeding causing sleepiness, but still arousable.

Late or Severe Seizures:
Is when the person is unconscious. Their eyes don’t open, even with stimulation. Loss of consciousness lasts more than 6 hours.

But a seizure disorder can develop days, weeks, a month or even years following a brain trauma!

The risk of future seizures and traumatic epilepsy is increased by each successive seizure. And the more severe the head trauma, the higher the risk of having seizures.

While many types of seizures may be caused by a traumatic incident, the most common are partial (focal) seizures or tonic-clonic (formerly known as grand mal) seizures.

An early seizure may not require treatment, but a seizure or two occurring later would be treated by many doctors with the usual anti-seizure medications, such as:

Tegretol (Carbamazepine), Lamictal (Lamotrigine), Keppra (Levitiracetam), Neurontin (Gabapentin, Trileptal (Oxcarbazepine), Phenobarbital, Dilantin (Phenytoin), Lyrica (Pregabalain), Topamax (Topiramate), Depakene or Depakote (Valproic Acid or Valproate) and Zonegran also known as Zonisamide.

Head trauma can also cause many problems in addition to seizures: migraine headaches, memory and concentration problems, dizziness, mood swings and various other symptoms known as the concussion syndrome.

Even after seemingly minor trauma, these symptoms can persist for months. With more severe head trauma, neurological symptoms can sometimes be permanent.

According to the CDC — Centers for Disease Control and Prevention:

About one-third of injury related American deaths are linked to TBI…
About 230,000 hospitalizations occur annually in the USA as a result of TBI…
1.1 million Americans are treated for TBI…
Almost 2% of the US population lives with TBI-related disabilities…
About 2 million American adults and children suffer from TBI annually…
50,000 patients die annually in America as a result of TBI…
Every 15 seconds one American man, woman or child sustains a traumatic brain injury…
11% of TBIs are caused by firearms — the leading cause of deaths related to TBI.

But there is hope for the future, regardless of whether your epilepsy is the result of Traumatic Brain Injury or not.

Promising New Research
Surgeons at Washington University School of Medicine in St. Louis are testing the ability of a cooling grid to reduce seizures that cannot be controlled through medication or surgery.

“Traumatic head injury is the leading cause of acquired epilepsy in young adults, and in many cases the seizures can’t be controlled with medication,” says Matthew Smyth, MD, associate professor of neurological surgery and of pediatrics at Washington University School of Medicine in St. Louis.

“If we can confirm cooling’s effectiveness in human trials, this approach may give us a safe and relatively simple way to prevent epilepsy in these patients.”

Cooling the brain to protect it from injury is not a new concept.

Cooling slows down the metabolic activity of nerve cells, and scientists think this may make it easier for brain cells to survive the stresses of an injury.

Doctors currently cool infants whose brains may have had inadequate access to blood or oxygen during birth.

They also cool some heart attack patients to reduce peripheral brain damage when the heart stops beating.

Smyth and his collaborators have been exploring the possibility of using cooling to prevent seizures or reduce their severity.

“Warmer brain cells seem to be more electrically active, and that may increase the likelihood of abnormal electrical discharges that can coalesce to form a seizure,” Smyth says. “Cooling should have the opposite effect.”

The study is the first to reduce injury-related seizures without drugs, according to Smyth, who is director of the Pediatric Epilepsy Surgery program at St. Louis Children’s Hospital.

“Our results show that the brain changes that cause this type of epilepsy happen in the days and weeks after injury, not at the moment of injury or when the symptoms of epilepsy begin,” says Smyth.

“If clinical trials confirm that cooling has similar effects in humans, it could change the way we treat patients with head injuries, and for the first time reduce the chance of developing epilepsy after brain injury.”

Other articles of interest:

Philadelphia researchers to create brain prosthesis to restore memory loss http://www.newsworks.org/index.php/homepage-feature/item/70216-philadelphia-researchers-to-create-prosthetic-brain-to-restore-memory-loss?linktype=hp_impact

Traumatic Brain Injury in the United States: Fact Sheet   http://www.cdc.gov/traumaticbraininjury/get_the_facts.html?s_cid=fb_tbi623

Study Finds Drug That Could Prevent Injury-Related Epilepsy http://www.shalomlife.com/health/23502/study-finds-drug-that-could-prevent-injury-related-epilepsy/

Striking a Nerve: TBI Survivors ‘Need an Advocate’   http://www.medpagetoday.com/CriticalCare/HeadTrauma/44210?xid=nl_mpt_DHE_2014-02-10&utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=WC&eun=g678262d0r&userid=678262&email=pfjohnson@comcast.net&mu_id=5845719

Commonly available blood-pressure medication prevents epilepsy after severe brain injury  http://www.sciencecodex.com/commonly_available_bloodpressure_medication_prevents_epilepsy_after_severe_brain_injury-132182

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Resources:

http://neurology.stanford.edu/epilepsy/patientcare/videos/e_12.html
http://www.msktc.org/tbi/factsheets/Seizures-After-Traumatic-Brain-Injury
http://braininjurylegalguide.com/traumatic-brain-injury-can-cause-seizures-and-epilepsy/
http://mnepilepsy.org/news/concussion-traumatic-brain-injury-and-seizures/
http://voices.yahoo.com/head-injuries-lead-seizures-7665356.html
http://www.brainline.org/content/2011/02/seizures-and-traumatic-brain-injury.html
http://www.hopkinsmedicine.org/neurology_neurosurgery/specialty_areas/epilepsy/seizures/causes/traumatic_brain_injury.html
http://news.wustl.edu/news/Pages/24985.aspx
http://www.medicalnewstoday.com/articles/179837.php
http://www.braininjury.com/seizures-and-head-injury.shtml


5 Comments »

  1. Reblogged this on darcil beyond abroad.

    Like

    Comment by darcil — April 13, 2014 @ 12:11 PM

  2. Oh! Oh! Oh! I Finally found a “clue”! My mother was pregnant with ME when she fainted from the weather in St. Louis Missouri! (hot, sticky, 103 degrees and 100&% humidity–I never DID learn why it did not rain then) Mother just plain blacked out! When she was back IN she was in Washington U.s hospital, under 4 fans, but that was not enough. They put her in a bathtub kind of “thing” and then poured ice shards over her body! I’ve heard that story! I need to phone my first cousin Paige (a girl—no, a grown woman with children and grandchildren) Then when I was 3 and had a fever of 105, they did the exact same thing with ME inside my tiny body. And THERE is the story of why we had air conditioned homes, cars, rooms, basements, you name it, we had it, the DOCTOR TOLD THEM WE NEEDED THEM TO SURVIVE (bless old Dr. Kaplan).

    Like

    Comment by Michele McKenzie — April 21, 2014 @ 2:30 PM

  3. Febrile seizures?

    “Most febrile seizures occur because of a sudden spike in body temperature, and most occur during the first day of a fever.

    Viral or bacterial infection

    Usually, the fevers that trigger febrile seizures are caused by a bacterial or viral infection in your child’s body. Typical childhood illnesses, including respiratory illnesses and infections such as roseola — a viral illness that causes swollen lymph nodes, usually in the neck, and a rash — are often associated with febrile seizures. A less common but very serious cause of sudden fever with seizures is an infection of a child’s brain and spinal cord (central nervous system), such as meningitis or encephalitis. These illnesses may also cause seizures without a fever.”

    http://www.mayoclinic.org/diseases-conditions/febrile-seizure/basics/causes/con-20021016

    Like

    Comment by Phylis Feiner Johnson — April 21, 2014 @ 4:19 PM

  4. Boy oh Boy, Phylis, my sweet, sweet, pal, don’t you have THAT one right! I had my first adult head injury in 1988—fell down my own padded metal stairs, and slammed the back of my head into the ornate brass doorknob on the front door, and was out like a light. My brother happened to be visiting at my home, that day. He came to me and shook me saying Mike (my childhood nickname) are you OK? Well, of course I THOUGHT I was OK. And so began the weirdest night of my LIFE! Later that evening, my mother and her friend Edie dropped by, (my mother still had a key to my house when I was 38!) and they began to methodically and with purpose, keep me on the first floor while mother went up to my bedroom to rifle my handbag for a health insurance card. Finding none that she could identify, I lost precious time while they tried to look in drawers, file drawers, and in other handbags for the insurance card. That woman (she is dead now, I can say evil things about her) passed up my PSA (Pacific Southwest Assurance Company) card, thinking it was a credit card for PSA airlines, (now defunct). Losing more time. They tried to get me to walk out to her car. Nope. Not to mention that she was CHEAP, and did not want to call 911, I lost more and more precious TIME. Finally, they used both of THEIR strengths plus the strength of my brother, to put me in the hatchback of the car. Driven to an auxillary of a REAL hospital, I was put on a gurney, where I lost MORE precious time. Hours passed. Finally someone put me into an ambulance and took me to a REAL hospital where I was warehoused on a floor next to a screaming male AIDS patient who was dying. And not quickly, but with great vigor. No one took MRIs, No one took a CT scan. They called in a psychiatrist. What? I could not put a real sentence together. They kept me for 5 days and released me to my mother’s care. She had to promise in writing that I would live with her until I was all better. You all know the story. I did not GET better. Then in 1991, I had my first seizure, on the front lawn of a friend of mine’s home. No one took me to a hospital then, either. Another psychiatrist was called in.DAMN! I los track of the many days and nights I slept through—it was YEARS! Then some idiot gave me Depacote, which gave me another seizure. Oh fooey. It took 11 years for my neuro to actually give me the correct medicine for me, Zonisamide. An E.R. doc who had never met me just handed me a paper cup, containing one pill. I slurred the question: “Will this make me more stupid?” He said no. I took the pilll. Life altering, in a wonderful way. Yes, I had several seizures in later years, but I was just trying to get the dosage right.Have you all put “grammarly.com into your computers? It is a game changer. Spell check AND grammar check. Spell check is free, grammar check is 12 dollars a month, but worth every penny especially if you want to be taken seriously by the medical community. I advise you all to get it. And no, I do not own it or have stock in it. And I get no money for mentioning it. I swear.

    Like

    Comment by meesher — October 12, 2016 @ 10:20 PM

  5. Michelle, what a fiasco! It seems like a comedy of errors, even though it’s not the least bit funny.

    Your poor sweetheart. If only…

    Like

    Comment by Phylis Feiner Johnson — October 13, 2016 @ 6:35 AM


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    About the author

    Phylis Feiner Johnson

    Phylis Feiner Johnson

    I've been a professional copywriter for over 35 years. I also had epilepsy for decades. My mission is advocacy; to increase education, awareness and funding for epilepsy research. Together, we can make a huge difference. If not changing the world, at least helping each other, with wisdom, compassion and sharing.

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