Citation

Hung C, Chen JWY. Curr. Treat. Options Neurol. 2012; 14(4): 293-306.

Copyright

(Copyright © 2012, Current Science)

DOI

10.1007/s11940-012-0178-5

PMID

unavailable

Abstract

Post-traumatic epilepsy (PTE) due to traumatic brain injury is a diagnosis with multifactorial causes, diverse clinical presentations, and an evolving concept of management. Due to sports injuries, work-related injuries, vehicular accidents, and wartime combat, there is rising demand to understand the epidemiology, pathophysiology, diagnosis, prognosis, and treatment of PTE. PTE could occur at any time after injury and up to decades post-injury. The frontal and temporal lobes are the most commonly affected regions, and the resulting epilepsy syndrome is typically localization related. PTE should be actively considered as a diagnosis in any patient with a history of head trauma and episodic neurologic compromise regardless of how temporally remote the trauma occurred. The standard work-up includes a thorough history, neurological examination, neuroimaging, and electroencephalogram. Psychogenic nonepileptic seizures have a high comorbidity with seizures and need to be carefully excluded. PTE can spontaneously remit. For patients who do not go into remission, treatment for confirmed PTE includes antiepileptics, vagal nerve stimulator, and, when appropriate, surgical resection of an epileptogenic lesion. Lifestyle modification and counseling are critical for patients with PTE and should be routinely included in clinical management. The published evidence on the efficacy of various treatment modalities specific to PTE consists largely of retrospective studies and case reports. Despite a unique pathogenesis, the majority of current care parameters for PTE parallel those of standard care for localization-related epilepsy. The potential and need for rigorous clinical research in PTE continue to be in great demand. © Springer Science+Business Media, LLC (outside the USA) 2012.

Language: en

Keywords

human; traumatic brain injury; insomnia; liver failure; Traumatic brain injury; suicidal ideation; patient safety; suicide attempt; drug abuse; kidney failure; pregnancy; fatigue; pancreatitis; article; anorexia; vomiting; behavior disorder; weight reduction; sedation; syncope; virus infection; patient monitoring; hallucination; somnolence; vertigo; appetite disorder; sleep disorder; coma; urine retention; drowsiness; nuclear magnetic resonance imaging; constipation; gastrointestinal symptom; Seizure; hostility; confusion; drug safety; seizure; neurosurgery; carbamazepine; nausea; tremor; weight gain; agranulocytosis; cost effectiveness analysis; Head injury; heart arrest; irritability; valproic acid; felbamate; gabapentin; phenobarbital; side effect; infection; asthenia; hepatitis; hypertrichosis; hypocalcemia; phenytoin; photosensitivity; pregabalin; QT prolongation; liver injury; positron emission tomography; drug contraindication; hyponatremia; Anticonvulsants; ataxia; nystagmus; etiracetam; oxcarbazepine; Prophylaxis; vagus nerve stimulation; zonisamide; thought disorder; electroencephalography; folic acid; angioneurotic edema; bradycardia; blood pressure; teratogenicity; calcium; bone marrow suppression; drug fever; aplastic anemia; diplopia; dizziness; drug eruption; megaloblastic anemia; neck pain; osteomalacia; slurred speech; Stevens Johnson syndrome; euphoria; schizophreniform disorder; memory disorder; liver disease; kinesiotherapy; atrioventricular block; drug induced headache; coordination disorder; jaundice; single photon emission computer tomography; acute intermittent porphyria; blurred vision; taste disorder; peripheral edema; liver function test; heart atrium fibrillation; heart atrium flutter; epidermolysis; acute liver failure; Continuous EEG monitoring; device therapy; erythroderma; folic acid deficiency; gingiva hypertrophy; harkoseride; hypercalciuria; ketogenic diet; neuromonitoring; Neuromonitoring; Post-traumatic epilepsy; retigabine; Seizure prevention; traumatic epilepsy