Posttraumatic Epilepsy
N. Paul Rosman MD1
Edgar Y. Oppenheimer MD2
1 Professor of Pediatrics and Neurology, Director of Pediatric Neurology, Associate Director of Pediatrics, Boston University School of Medicine, Boston City Hospital, Boston
2 Assistant Professor of Pediatrics and Neurology, Boston University School of Medicine; Director of Pediatric EEG Laboratory, Boston City Hospital, Boston
Head trauma is an important cause of epilepsy in children. Posttraumatic seizures are divided into those that occur within the first week following the head injury (early posttraumatic epilepsy or early PTE), and those that occur after the first week (late PTE). Early PTE occurs in approximately 5% of children hospitalized following head trauma. The more severe the head injury, the greater the risk of early PTE. Late PTE also occurs in approximately 5% of children hospitalized after head trauma. As with early PTE, the risk for late seizures is greater in individuals who sustain more severe head injuries. Also, late PTE may be more likely to arise if early PIE has occurred. The EEG is not helpful in the prediction of late PTE. Acute treatment of posttraumatic seizures is essentially the same as that used for nontraumatic seizures. The efficacy of pharmacologic treatment for the prophylaxis of late PTE in headinjured patients remains uncertain.
