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Epilepsy and seizures may be missed following head trauma

Epilepsy may be missed in patients recovery from brain trauma, particularly those suffering a cerebral hemorrhage according to studies which were reported  at the American Epilepsy Society 64th Annual Meeting.

One new study found that at least one quarter of patients in intensive care with a cerebral hemorrhage who underwent evaluation with continuous electroencephalography (cEEG) were diagnosed with subclinical seizures, mostly status epilepticus.

In this study, "The overwhelming majority of patients who had seizure activity were having subclinical or nonconvulsive seizures; in other words, this isn't something you can see with the naked eye," said lead investigator Jeffrey M. Politsky, MD, director, Research, Northeast Regional Epilepsy Group, and medical director Atlantic Neuroscience Institute Comprehensive Epilepsy Center, also in Summit. The authors recommend that these patients be evaluated for subclinical seizure activity to avoid further brain damage.

A second study showed that children with an acute brain injury had more than double the rate of early posttraumatic seizures (EPTS) of adults with similar injuries.

"We know that children have a high rate of early posttraumatic seizures when they have moderate or severe injuries, but this rate of 56% is even higher than what has been shown in past clinical studies," said lead investigator Daniel Arndt, MD, director of the Pediatric Epilepsy Program at DeVos Children's Hospital, Grand Rapids, Michigan.

The study results  suggest that it might be prudent for all children with head injuries to be monitored with EEG to detect subclinical seizures according to the study authors. 

 

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