Handbook of Neurotrauma: Volume 2: Cranial Trauma by Sinha Sumit

Author:Sinha, Sumit [Sinha, Sumit]
Language: eng
Format: epub
Publisher: Salubris Publishers
Published: 2021-03-11T16:00:00+00:00

Figure 1 Management algorithm for seizures following traumatic brain injury (TBI). (AED-antiepileptic drugs; PNES-psychogenic non epileptic seizures; vEEG-video electro encephalogram; MRI- magnetic resonance imaging; CBT-cognitive behavioral therapy)

Key Points

⇨ Clear differentiation between post traumatic seizure and epilepsy, the former is provoked and occurs within one week of trauma, while the latter occurs one week later.

⇨ Risk factors for PTE should be kept in mind while starting AEDs and in order to prognosticate patients regarding the risk of developing PTE.

⇨ Recognition of latent period before developing PTE, which might be long and thus there is a need for vigilance during follow up.

⇨ Metabolic derangement should be ruled out as a cause, and imaging in form of CT/MRI is helpful.

⇨ AEDs (phenytoin/levetiracetam) are recommended to prevent post traumatic seizures (up to 7 days after TBI), their role in preventing PTE is doubtful.

⇨ Surgery is indicated in drug refractory epilepsy, with similar outcomes as non-trauma patients.

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