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Exacerbation of Pre-existing Epilepsy by Mild Head Injury: a Five Patient Series

Published online by Cambridge University Press:  02 December 2014

P.C. Tai
Affiliation:
Division of Neurology, University of Alberta, Edmonton, Alberta, Canada
D.W. Gross
Affiliation:
Division of Neurology, University of Alberta, Edmonton, Alberta, Canada
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Abstract

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Objective:

While the risk of developing seizures following a mild head injury has been reported and is thought to be low, the effect of mild head injury on patients with a pre-existing seizure disorder has not been reported. We present a series of cases where a strong temporal relationship between mild head injury and worsening of seizure frequency was observed.

Methods:

Five cases were identified and reviewed in detail. Information was derived from clinic and hospital charts with attention to the degree of injury, pre- and postinjury seizure patterns and frequency.

Results:

One patient has primary generalized epilepsy and four have localization related epilepsy. Prior to the head injury, three of the patients were seizure free (range: two to 24 years). The patients suffered from mild head injuries with no or transient loss of consciousness and no focal neurological deficits. In all cases, the patients experienced a worsening of seizure control within days of the injury. In one case, the patient's seizure pattern returned to baseline one year after the accident, while in the remaining four cases, the patients continue to have medically refractory seizures.

Conclusion:

A close temporal relationship between mild head injury and a worsening of seizure control was observed in five patients with epilepsy. Although further study is required, this observation suggests that a head injury that would be considered benign in the general population can have serious consequences such as recurrence of seizures and medical intractability in patients with epilepsy.

Type
Research Article
Copyright
Copyright © The Canadian Journal of Neurological 2004

References

1.Salazar, AM, Jabbari, B, Vance, SC, et al.Epilepsy after penetrating head injury, I. Clinical correlates: a report of the Vietnam Head Injury Study. Neurology 1985;35:14061413.Google Scholar
2.Annegers, JF, Hauser, WA, Coan, SP, Rocca, WA.A population based study of seizures after traumatic brain injuries. N Engl J Med 1998;338:2024.Google Scholar
3.Annegers, JF, Grabow, JD, Groover, RV, et al.Seizures after head trauma: a population study. Neurology 1980;30:683689.CrossRefGoogle ScholarPubMed
4.Caveness, WF, Meirowsky, AM, Rish, BL, et al.The nature of posttraumatic epilepsy. J Neurosurg 1979;50:545553.Google Scholar
5.Hosokawa, C, Inoue, Y, Yoshimura, H, et al.Transient increase in cerebral blood flow in a patient with Sturge-Weber syndrome. J Comput Assist Tomogr 1998;22(6):980983.Google Scholar
6.Miller, VS, Roach, ES.Neurocutaneous Syndromes. In: Bradley, WG, Daroff, RB, Fenichel, GM, Marsden, CD (Eds). Neurology in Clinical Practice. 3rd ed. Butterworth-Heinemann 2000:1683.Google Scholar
7.Clear, D, Chadwick, D.Seizures provoked by blows to the head. Epilepsia 2000; 41(2):243244.Google Scholar
8.Westbrook, LE, Devinsky, O, Geocadin, R.Nonepileptic seizures after head injury. Epilepsia 1998;39(9):978982.CrossRefGoogle ScholarPubMed
9.Haut, SR, Vouyiouklis, M, Shinnar, S.Stress and epilepsy: a patient perception survey. Epilepsy Behav 2003; 4(5):511514.CrossRefGoogle ScholarPubMed