Post traumatic epilepsy : An analysis of interesting spectrum of cases at a tertiary care neurosurgical centre

Abstract

Objective: We present some unusual cases of post traumatic epilepsy managed in the high care unit of a tertiary care neurosurgical centre. They were thouroughly evaluated to determine the cause of post traumatic epilepsy. The pathogenesis of Post Traumatic Epilepsy which provides insights into neural injury, rewiring and regeneration paradigms is discussed. Materials and methods: Six male patients aged 19-35 years who suffered head injury and suffered post traumatic epilepsy were enrolled & observed during their hospital stay. They underwent neuroimaging and EEG monitoring to rule out other causes of epilepsy. Two patients were lost due to death. Results: All patients suffered Parenchymal injury. Seizure spectrum included not only motor but also autonomic manifestations. The Autonomic manifestations were more resistant to antiseizure medication but responded to SOS treatment Seizure threshold is probably reduced during episodes of wound site infection, URTI or urinary infections Conclusion: The mechanisms causing seizures in TBI patients are incompletely understood. In our set of patients, the common thread that runs through these cases is that they all had severe brain insults followed by post traumatic epilepsy. Cortical lesions seem important in the genesis of the epileptic activity, and early seizures are likely to have a different pathogenesis than late seizures.

Keywords

• Post traumatic seizures
• to epileptogenesis
• Traumatic Brain Injury