One of the many effects of traumatic brain injury that a person can develop is epilepsy.
Even though epilepsy after TBI is somewhat rare, it is important to understand what it is and what to do if you ever experience seizures after your brain injury.
It’s also critical for your loved ones to know the signs preceding a seizure and how they can keep you safe.
In this article, we’ll cover the factors that can put you at risk for epilepsy after TBI, what to do when a seizure occurs, and what treatments are available for managing seizures.
What Is Epilepsy?
A seizure is caused by an electrical disturbance in the brain. If you experience multiple seizures regularly, then you probably have epilepsy.
Epilepsy that develops after a TBI is known as post-traumatic epilepsy. (PTE) About 5% to 10% of traumatic brain injury patients develop PTE.
If you experience a seizure after your TBI though, this doesn’t automatically mean you have developed post-traumatic epilepsy. You need to have multiple seizures before you are considered epileptic.
What Causes Epilepsy After TBI?
The cause of epilepsy after TBI is not fully known, however, researchers have been able to identify certain factors that put people at higher risk of seizures. These include:
- Brain bleeds. Patients experience brain swelling and bleeding after TBI have a much higher risk of seizures.
- Penetrating head injuries. Patients with penetrating head injuries, such as gunshot wounds, are at the greatest risk of developing epilepsy after TBI.
- Antidepressants and alcohol. Alcohol and certain drugs such as antidepressants can increase your risk of seizures regardless of brain injury, but after a TBI the likelihood is even greater.
It should be noted that you can experience seizures after brain injury even if none of these factors apply to you. These are just the most common factors doctors have identified.
Generally, the more severe the head injury, the greater your likelihood of developing PTE.
When Do Seizures After TBI Occur?
In most cases, a seizure will happen in the first few days after a TBI.
Every case is different though, and some have been known to occur months and even years post-head injury.
Research has indicated that the later a seizure happens after a TBI though, the more likely it is you will develop epilepsy.
What Happens Before A Seizure?
A seizure has a set sequence of events that happen before a person begins convulsing uncontrollably.
It is important to know and recognize these signs so you can respond appropriately and avoid injury.
Stage 1: Aura Phase
A person about to have a seizure will experience certain warning signs before the actual seizure happens (called an aura). These are signs only the person about to have a seizure will notice.
If you experience any of these signs, get yourself into a safe position immediately:
- Unusual smells or tastes
- “Out of body” sensations
- People you know feeling unexpectedly strange to you, as if you’ve never met them.
- Tingling or feelings of electricity in body
- Confusion and headaches
Usually after the aura passes, they will become unresponsive. They won’t answer when you call and won’t blink if you wave your hand in their face.
Stage 2: Tonic Phase
Next, the person’s muscles will clench and they will become stiff and rigid. This is called the tonic phase and it usually only lasts a few seconds. They may collapse. Try to prevent them from falling by lowering them slowly to the ground.
Stage 3: Clonic Phase
This is when jerking movements of the face, arms and legs become the most intense. This phase usually lasts only one to three minutes, then the movements will slow down and the body relaxes.
Stage 4: Postictal Period
After a seizure, the person may remain unconscious for several minutes. This is no cause for alarm, their brain is just trying to recover.
What to Do When Someone Has a Seizure
A seizure can be frightening to witness, but here is what you should do when you when you see someone has a seizure.
- Get them to the ground safely. If they are in a bed or chair, move them slowly down to the ground, but DO NOT try to hold them still. That will only hurt them more and could cause injury to yourself.
- Turn them to their side. This prevents them from choking.
- Do not put anything in their mouth. Some people may be tempted to put something in the person’s mouth to keep them from biting their tongue, but this is extremely dangerous.
- Time the seizure. If a seizure lasts more than 5 minutes, call 911 immediately.
- Offer reassurance. After a seizure ends, the person is going to be confused and anxious, and possibly embarrassed. Comfort them and let them know everything will be ok.
Can Epilepsy After TBI Be Treated?
Absolutely! Even though epilepsy is often a lifelong condition, there are several anti-seizure medications available that can help reduce seizure frequency and severity and get your epilepsy under control.
There is also a device called a vagus nerve stimulator that can stimulate your nerves with electrical impulses to prevent seizures.
Whichever treatment you choose, it’s always good idea to set up a Seizure Response Plan with your family and friends.
Having a thorough response plan will help you manage your epilepsy effectively and let you live your life again without fear.