Epilepsy Talk

Traumatic Brain Injury and Epilepsy | February 16, 2019

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:

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

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

To subscribe to Epilepsy Talk and get the latest articles by email, simply go to the bottom box of the right column and click on “Follow”

Resources:

http://www.msktc.org/tbi/factsheets/Seizures-After-Traumatic-Brain-Injury
http://mnepilepsy.org/news/concussion-traumatic-brain-injury-and-seizures/
http://www.brainline.org/content/2011/02/seizures-and-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


29 Comments »

  1. Good afternoon Phyillus 😊. That is VERY UNDERSTANDABLE!! I have had grandmal seizures apparently since I was a baby, but it was diagnosed until I was 8 years old. I was very active as a hound person in a quite few different sportIng events. I even maintained that coaching my children in hockey, baseball, soccer etc. However about 4 years ago I had a seizure and fell down my front outside doorsteps. After that everything seemed to change dramatically! Even to here and now. My vision has changed, my balance and it’s tough to be around lots of people when it never used to be an issue!! The hard part was getting the proper family doctor who actually understood and cared enough to want to learn more of how to help me. Thank goodness I have a STRONG SUPPORTIVE HUSBAND, CHILDREN and spectre few friends and people who help me ❤️. Either by slowing me down, just wanting to be with me and most of all PATIENT ENOUGH TO LOVE AND CARE FOR ME through it all! Because sometimes even my own biological family give up on me or think “there’s always something wrong with me!!!!”. That hurts, but it hurts even more NOT to have the SUPPORT AND UNDERSTANDING by my OWN FAMILY DOCTOR AND NEUROLOGIST!!!!!!! I know myself best (most of the time) and I just wish they would listen to me when I tell them what works and what doesn’t!! Thank you SOOOOO MUCH FOR BRING THIS TO LIGHT!! 🙏🏼💕. I WISH EVERYONE was as understanding, compassionate, caring and WANTING TO HELP not only us as “EPILEPTICS”, but in general. Thank you SO MUCH!! 🙏🏼❤️

    Liked by 1 person

    Comment by Kathy S.B — February 16, 2019 @ 7:19 PM

    • It’s sad to be misunderstood by your biological family, but unforgivable to be brushed aside by your Family Doc and Neurologist.

      Unfortunately, it’s probably because of their ignorance and/or lack of understanding. YOU (and only you) know your body best.

      But how lucky you are to be surrounded by patience, love, care and support.

      That speaks volumes about both you and your loved ones in itself.

      Liked by 2 people

      Comment by Phylis Feiner Johnson — February 16, 2019 @ 8:06 PM

  2. Head trauma can also damage the pituitary gland, cause adrenal insufficiency, when the pit isn’t able to send the hormone ACTH to the adrenal glands. It is now a documented cause of central adrenal insufficiency, although many doctors aren’t aware of this!

    Liked by 2 people

    Comment by gailmcarthur — February 16, 2019 @ 8:09 PM

    • Sounds like you “HIT THE NAIL ON THE HEAD” Gail!! Thank you 😊. Now just to get NEUROLOGISTS AND FAMILY DOCTORS to realize that maybe you hose that are injured or have a neurological problem will get ALL THE HELP WE/THEY NEED!!!!! My family doctor kept telling me my sodium is consistently low!! I WISH THEY BOTH READ THIS!!!!! 🙏🏼💕

      Liked by 2 people

      Comment by Kathy S.B — February 16, 2019 @ 10:17 PM

      • I’m SO SORRY GAIL!! I meant “THOSE THAT ARE INJURED OR HAVE NEUROLOGICAL PROBLEMS” WILL GET THE HELP WE NEED!! Other than just giving us some form of “LAXATIVE” for our stomachs!! Because in all honesty for me it makes it so I DON’T WANT TO EAT ANYMORE!!!!!!! But I live in Alberta, Canada which may differ from the country or the “United States of America”. 💕

        Liked by 1 person

        Comment by Kathy S.B — February 16, 2019 @ 10:43 PM

      • Kathy, I live just east of Vancouver, in the Fraser Valley! It took me a while to get my diagnosis, but I eventually found a neuro-endo who works at research clinic in a Vancouver hospital. I’m now an advocate for patients with all forms of adrenal insufficiency.

        Liked by 2 people

        Comment by gailmcarthur — February 16, 2019 @ 11:56 PM

    • Good afternoon Gail 😊. This is Kathy I hope your well and doing good 😊. Well Gail I think I may just make my way your way soon!! Because I’m starving and haven’t eaten for 11-12 days!! It sounds like your doctor IS WAY MORE KNOWLEDGEABLE THAN MY LITTLE TOWN DOCTOR!!!!! 😊.

      Liked by 1 person

      Comment by Kathy S.B — May 19, 2019 @ 4:31 PM

  3. Reblogged this on catsissie.

    Liked by 1 person

    Comment by catsissie — February 16, 2019 @ 11:08 PM

  4. OMG. Laxatives? WTF is the matter with them?

    Are we talking Middle Ages here?

    Liked by 2 people

    Comment by Phylis Feiner Johnson — February 16, 2019 @ 11:13 PM

    • Yes. They put me on them because the calcium I and iron I was on were causing bowel issues. They cut my calcium levels down and put me on the laxitives. Apparent the calcium was causing “stones” in my stomach or liver and I required the iron. The laxative was supposed to help me because of constipation the iron was causing me. The stones weren’t removed because apparently they were too small and my family doctor never discussed it with me

      Liked by 1 person

      Comment by Kathy S.B — February 16, 2019 @ 11:27 PM

      • I apologize I am 48 years old. I also refused to go on “Auro-Levetiracetam” 500mg twice a day. Because I DID NOT LIKE the side-effects of that medication. My neurologist was NOT HAPPY WITH ME!! However it felt like a DANGEROUS GAMBLE I WASN’T WILLING TO TAKE!!!!! For myself or my husband and children and friends.

        Liked by 1 person

        Comment by Kathy S.B — February 16, 2019 @ 11:41 PM

  5. Yes. Mine started by fall onto grocery store while working. , fell on head, take to hospital. 1 month later seizure began, didnt know at time what it was, 2019 there drifting away looks totally, but 50 years later. New pill.

    Liked by 1 person

    Comment by Mel Bojoe — February 17, 2019 @ 12:27 AM

  6. Kathy, maybe it’s time for a different neurologist. I’m happy with mine. He’s in Edmonton, and his name is Dr. Muratoglu. He’s also an associate professor at the U of A.

    Liked by 2 people

    Comment by Marlyn — February 17, 2019 @ 2:31 AM

    • Thanks for all the help and input ladies.

      And the recommendation, Marilyn!

      It will go on my “Top Docs” list.

      2019 Patient Recommendations for TOP Neurologists…Epileptologists…Neurosurgeons…and Pediatric Doctors

      https://epilepsytalk.com/2019/01/03/2019-patient-recommendations-for-top-neurologistsepileptologistsneurosurgeonsand-pediatric-doctors/

      Liked by 1 person

      Comment by Phylis Feiner Johnson — February 17, 2019 @ 9:48 AM

    • Goodevening Marlyn 😊. I was just wondering if you please tell me what an “ACTH” is? And how to be able to do things to help myself so my doctor doesn’t think I’m making anything up! I will admit due to the nature of my “OWN FAMILY” and then “EXTENDED FAMILY” plus doctors it made it difficult to know exactly what to say and who to ask anymore? Lol MINUS my animals lol because they just list and are ALWAYS LOYAL!! ❤️

      Liked by 1 person

      Comment by Kathy S.B — February 17, 2019 @ 11:01 PM

      • Adrenocorticotropic hormone (ACTH) is a hormone produced in the anterior, or front, pituitary gland in the brain.

        The function of ACTH is to regulate levels of the steroid hormone cortisol, which released from the adrenal gland.

        As for what to say, you might want to take notes on what and how you’re feeling — maybe keep a daily diary — and then go (literally) by your gut.

        Liked by 1 person

        Comment by Phylis Feiner Johnson — February 18, 2019 @ 10:28 AM

      • Goodmorning Phyillus 😊. I bet that’s why particularilly my left side of my stomach is CONSTANTLY HURTING!!!!! Which is exactly why I don’t even want to eat!! Honestly the digestion part is EXTREMELY PAINFUL therefore I don’t eat very much anymore!! I WISH ALL DOCTORS AND NEUROLOGISTS WERE YOU!! 💕

        Liked by 1 person

        Comment by Kathy S.B — February 18, 2019 @ 11:46 AM

      • Yes, take notes on how you’re feeling, and include anything your loved ones notice. Bring it with you to your doctor, as well as a witness if you can. It’s nearly impossible to remember what to tell your doctor.
        I don’t know anything about ACTH so I can’t help you there, but if you feel you need another opinion, don’t feel bad about seeing another doctor. My old GP retired over a year ago and he was great, and with this other GP I now have, I realize how much my old but loved doc actually missed or let slide.
        Let your gut be your guide.
        Best of luck, Kathy.

        Liked by 2 people

        Comment by Marlyn — February 18, 2019 @ 12:10 PM

  7. And I imagine as many or more people develop epilepsy who have NOT had a traumatic brain injury. But, I do wonder what the parents who pushed their kids to play football for years will say when their kids begin seizing. Where I live, they probably rate epilepsy and if it’s from playing football it’s acceptable, otherwise not. I know, we need to move. Thanks.

    Liked by 1 person

    Comment by Susan — February 17, 2019 @ 1:04 PM

  8. Susan, although this doesn’t have to do with kids, you might appreciate this article:

    A Fallen Football Hero…

    https://epilepsytalk.com/2018/10/27/a-fallen-football-hero/

    Like

    Comment by Phylis Feiner Johnson — February 17, 2019 @ 1:11 PM

    • Goodmorning Phylis this is Kathy S.B. I hope you doing good 😀. Well Phylis is have something you maybe interested in!! It’s been a constant with me and it broke through yesterday and landed me in E.R. ONCE AGAIN!!!!! It is STOMACH ACHES LIKE NOBODY COULD EVER BELIEVE!!!!! ONCE AGAIN APPARENTLY MY SODIUM AND BLOOD PRESSURE ARE EXTREMELY LOW!!!!!!! Which is beginning to feel normal (SUCK IT UP!!). However this time they may have something. Or maybe? They ran bloodwork, toxicology tests, and did xrays on my stomach. I am too old (48yrs old PROUDLY) for “appendicitis” so the Doctor is suspecting something called “SSADH”. I have to go back for MORE BLOODWORK AND A POSSIBLE ULTRASOUND TODAY because my digestive system (“bowels”) seem to be constantly FULL and YET I NEVER HARDLY EAT!!!!!!! It’s left me JUST SHAKING MY HEAD IN A FEELING OF UNCERTAINTY AND UNREAL!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

      Liked by 1 person

      Comment by Kathy S.B — May 13, 2019 @ 10:45 AM

      • Stopped up bowels bowels can trigger seizures, but the rest is a mystery to me.

        (And I guess the docs.)

        But I’m really glad you, and they, are being proactive.

        Liked by 1 person

        Comment by Phylis Feiner Johnson — May 13, 2019 @ 10:53 AM

  9. Well I am HONESTLY NOT SURE WHAT TO THINK to be honest with you ❤️

    Liked by 1 person

    Comment by Kathy S.B — May 13, 2019 @ 10:59 AM

    • I really feel for you.

      But hopefully they’l find a cause and effect and you’ll be properly treated.

      The diagnosis is the main thing.

      And hopefully, you’ll have answers soon.

      Like

      Comment by Phylis Feiner Johnson — May 13, 2019 @ 11:01 AM

  10. I HAVE A STRONG FEELING THAT’S WHAT COULD BE CAUSING THE “SYNTHENASA”

    Liked by 1 person

    Comment by Kathy S.B — May 13, 2019 @ 11:08 AM

  11. Oh boy. “If it’s not an ass, it’s an elbow.”

    Hope things get resolved sooner, rather than later!

    Like

    Comment by Phylis Feiner Johnson — May 13, 2019 @ 11:53 AM

  12. Thanks so much for sharing, Phylis! Since I have been dealing with this for years, it has morphed. Now, I haven’t had seizures, but debilitating migraines and fatigue. Part of it may be from brain changes, part from stress, and part from people’s ignorance.

    Liked by 1 person

    Comment by megambon2164 — July 23, 2019 @ 12:20 PM

  13. I think the migraines are probably contributing to the stress on your brain.

    Epilepsy & Migraines — Kissing Cousins

    https://epilepsytalk.com/2019/03/18/epilepsy-migraines-kissing-cousins/

    Like

    Comment by Phylis Feiner Johnson — July 23, 2019 @ 12:24 PM


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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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