When seizures are not trivial!

Abstract

We report the case of a 29 year old woman with post traumatic epilepsy which began at 20 year old. She presented multi-daily absence seizures, motor automatisms and headaches. Brain CT-scan performed, highlighted several punctiform hyperdense images like calcifications leading to the conclusion of intracerebral and subcutaneous bullet fragments. Her personal history reported head injuries at the age of 2 years in a context of unexplored and little followed armed conflict. Awake and sleep EEG found a well-organized EEG diagram with diffuse inter ictal spikes and spike-waves discharges mainly in bi-fronto-temporal area compatible with focal epilepsy with secondary generalization. Valproic acid 1500 mg/day had been used and evolution at 3 months (April 2020) found no seizures increasing, sometimes headaches relieved by drugs.

Keywords

• posttraumatic epilepsy
• traumatic brain injury
• intracerebral bullet fragments