A phenomenon such as epilepsy after a head injury is recognized without problems, by symptoms, and seizures due to TBI, special treatment is necessary.
The development of painful seizures after trauma is typical for people who have an initial predisposition to epilepsy. Doctors come across cases when such patients have previously encountered epilepsy of one type or another, and after a head injury, the seizures have resumed or intensified. However, severe brain injury or pinpoint neuronal damage leads to epilepsy, even in initially healthy people.
The seizures that occur against the background of the disease are different in strength. They can be almost invisible and not interfere, but they can also be strong, life-threatening.
Causes
Traumatic epilepsy does not occur in everyone with TBI; after a head injury, a neurological examination must be performed to determine if there is a risk of developing the disease.
It is worth expecting the onset of seizures in people with the following characteristics:
- extensive foci of neuronal death;
- ischemia of certain parts of the brain;
- hematomas – subdural, intracerebral;
- depressed fractures of the bones of the skull;
- coma;
- gunshot wound.
Seizures should not be expected immediately after an injury. As a rule, they come after the exit from an acute state, when scars form instead of dead healthy tissues.
So post-traumatic epilepsy can be symptomatic.
In addition to the direct occurrence of epilepsy against the background of traumatic brain injury, the risk of developing the disease and severe treatment after receiving a blow to the head are represented by the following factors:
- endocrine system diseases;
- alcoholism;
- taking certain medications;
- genetic predisposition;
- diseases of the nervous tissue;
- anomalies in the structure of cerebral vessels.
A person without deviations from the norm, leading a healthy lifestyle, has a low chance of developing an epileptic syndrome. Of course, it all depends on the severity of the injury, but the recovery of brain function in such patients is much faster.
Symptoms
A characteristic symptom of the disease is seizures that occur at different intervals. Moreover, they can be associated with a head injury, even a mild one.
If the damage was accompanied by loss of consciousness, hematoma, then the seizures after this are most likely caused by the trauma. Children require attention: their skull bones are soft and after a blow, for example, on the corner of the bed, it is difficult to notice the damage outwardly.
Convulsions can be minor in manifestation, not interfering with life and recovery. However, there are also full-fledged seizures that are dangerous to health and life.
In terms of prognosis, weight has the severity and duration of the seizures. If epilepsy does not go away after a blow to the head after the end of the recovery period, then its treatment will take time.
Often, some time before the attack (from 20 seconds to 1-3 hours), there are symptoms-harbingers of a painful condition. They are called aura.
Common manifestations of the aura:
- nausea;
- severe anxiety for no apparent reason;
- violation of appetite;
- stomach ache;
- insomnia;
- headache;
- severe irritability;
- depression.
Each person has their own list of triggers that provoke the development of a seizure. As a rule, these are alcohol intake, loud noises, flashes of light, severe stress, physical overload.
The attacks themselves can vary in severity and manifestation. Convulsive manifestations are not always found.
Probable symptoms of an epileptic seizure after TBI:
- loss of consciousness;
- temporary loss of orientation in space;
- short-term amnesia;
- muscle twitching;
- throwing your head back;
- involuntary loud sounds;
- foam at the mouth;
- involuntary bowel movements and urination;
- involuntary twitching of the limbs;
- temporary freezing is an absence variant of epilepsy.
Epileptic seizures can occur months after the injury, so people with TBI should be monitored.
Any deviation from the usual behavior, the feeling of your body, should disturb the person.
Effects
Even if epilepsy results in rare, life- free seizures without seizures, it must be treated. Because, without manifesting itself physically, it damages the work of the brain, provoking degradative personality changes.
Common consequences of traumatic epilepsy:
- sharp frequent mood swings;
- gradually deteriorating memory;
- personality changes;
- loss of logical thinking;
- the appearance of manias;
- dementia
A person ceases to think sensibly, his orientation in space and time suffers. Aggressiveness or depression often develops.
Most of the consequences can be avoided if treatment is started on time. And in the future – to avoid factors provoking seizures.
Diagnostics
People who have received TBI need to undergo an examination not only before the course of therapy, but also after the end of treatment. And then for at least another year, periodically visit a neurologist to monitor the condition.
When treating a person with manifested seizures, an extensive neurological examination is required, which consists of the following stages:
- Clarification of the clinical picture. When questioning, the strength, frequency of seizures, their typical signs, provoking causes, are found out.
- EEG electroencephalography helps to establish the fact of epilepsy even between seizures.
- MRI is a neuroimaging method that shows degradative changes in the cerebral cortex, tumors, cysts, fluid accumulations that affect the patient’s condition.
In the acute period, the first hours after the injury, head echoencephalography is shown. The method is accessible and informative in terms of identifying intracranial hematomas.
After receiving the results of the study, therapy can be prescribed.
Treatment
Treatment of post-traumatic epilepsy differs from the treatment of other options: it is necessary to correct the resulting brain damage. The therapy is carried out with conservative methods, aimed at eliminating seizures that can affect the functioning of the brain. If you follow all the doctor’s recommendations, you can count on a complete cure.
The drugs are prescribed strictly to each patient, in dosages acceptable for each case. The course of treatment can last from months to 5 years or more.
Medicines are used as anticonvulsants:
- lamotrigine;
- levetiracetam;
- clonazepam;
- depakin;
- defenin;
- carbamazepine.
Additionally, medications are prescribed that help improve blood supply, correct existing damage.
In addition to regularly taking medications, the patient needs to change his lifestyle by giving up harmful factors. Reasonable, physician-approved physical activity and special diet are also beneficial in speeding up recovery.