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Seizures After Head Injury: Urgent Facts You Need to Know

woman helping a man experiencing seizure after head injury

Experiencing a seizure after head injury is a frightening experience.

This side effect of traumatic brain injury can be dangerous. Therefore, both TBI survivors and caregivers should understand how to handle a seizure if and when it occurs. 

Symptoms of Seizures After Head Injury

Seizures occur when there is sudden, disorganized electrical activity in the brain. This happens for a variety of reasons, but whatever the cause is, the normal electrical signals the brain sends somehow lose their proper path and end up crossing each other.

This causes the brain and body to, essentially, short-circuit.

According to the CDC, about 10 percent of head injury patients who require hospitalization will experience a seizure. During a seizure, the electrical disturbance in the brain can cause several of the following symptoms:

  • Strange, jerking movements of the head, body, arms, legs, and eyes
  • Unresponsiveness and staring
  • Lip smacking
  • Sudden tiredness and/or dizziness
  • Inability to speak or understand others

The seizure itself usually lasts only a few seconds or minutes. Once it ends, you may feel weak or confused, but those feelings eventually wear off.

Causes of Seizures After Head Injury

The reason seizures occur after a head injury is not fully understood; however, researchers have identified certain factors that put people at higher risk of developing seizures after a brain injury. These include:

  • Brain bleeds  
  • High fever
  • Loss of sleep
  • Penetrating head injuries     
  • Antidepressants and alcohol   

You can still experience seizures after brain injury even if none of these factors apply to you. These are just the most common factors doctors have identified.

When Do Seizures after Head Injury Occur?

Generally, the most likely time for a seizure to happen is within the first 24 hours after a brain injury.

Doctors will usually classify seizures based on when they occur.

  • Early post-traumatic seizures occur within the first seven days after injury.
  • Late post-traumatic seizures occur after seven days.

Eighty percent of people who experience late seizures will develop post-traumatic epilepsy. Epilepsy causes a person to have multiple, unprovoked seizures for the rest of their life.

However, everyone is different and every head injury is unique, so this can vary greatly from person to person.

Types of Seizures after Head Injury

There are two main categories of post-traumatic seizures:  

  • Provoked seizures usually occur immediately after a head injury but are caused by something else, such as a severe infection, high fever, or kidney failure.
  • Unprovoked seizures happen at least a week after a TBI but are not caused by anything external like an infection.

Multiple, unprovoked seizures will usually lead to a post-traumatic epilepsy diagnosis.  

Seizure Warning Signs

girl rubbing her head in a crowded street, looking worried because she is about to have a seizure after head injury

©iStock/AntonioGuillem

Before a seizure occurs, the person will sometimes experience strange sensations (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 the body
  • Confusion and headaches

Usually, after the aura passes, the person will become unresponsive. They won’t answer when you call and won’t blink if you wave your hand in their face.

What Should You Do When Someone Is Having a Seizure?

Knowing how to properly help someone who is having a seizure is critical for their health and safety.

If you are a TBI survivor, be sure to share this information with your friends and family so that they know how to assist if you have a seizure.

When someone near you starts having a seizure, you should:

  • Loosen any tight clothing. Especially around their neck.
  • Get them to the ground and roll them to their side. This will help prevent possible injury and choking.
  • DO NOT hold the person down. Holding them still will only hurt the person more.
  • DO NOT put anything in the person’s mouth. This poses a major choking hazard.
  • Time the seizure. If a seizure lasts more than 3 minutes, call 911 immediately.
  • Offer reassurance. After a seizure ends, the person will be confused and anxious, and possibly embarrassed. Comfort them and let them know everything will be ok.

Treating Seizures After Head Injury

Fortunately, there are several anti-seizure medications available that can help reduce seizure frequency and severity.

Some of the most common medications that doctors prescribe for seizures include:

  • Carbamazepine
  • Gabapentin 
  • Phenobarbital
  • Valproic acid or valproate

If those medications do not help, doctors can implant a vagus nerve stimulator to your neck. This device stimulates your nerves with electrical impulses to prevent seizures. 

Safety Concerns

doctor explaining seizure safety protocols to her head injury patient

If you have frequent seizures, many areas of your life will have to change to ensure your safety. For example, you must:

  • Quit driving until seizures have completely stopped
  • Always have someone with you if you are in or near water
  • Avoid climbing on ladders, roofs, or other tall objects
  • Never eat alone, and tell the people with you what to do if you have a seizure and choke

As inconvenient as some of these rules sound, following them can often mean the difference between life and death.

Living with Seizures After Head Injury

Although seizures are frightening, you can get them under control with the right treatment.

Whichever treatment you choose, it’s always a good idea to set up a Seizure Response Plan with your family and friends.

Having a thorough response plan will help you manage your seizures effectively and let you live freely without the fear of seizures holding you back.

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