Posttraumatic epilepsy in civilians: clinical and electroencephalographic studies

Posttraumatic epilepsy (PTE) is a known consequence of head trauma. The factors involved in posttraumatic seizures generation and the relationship between acute seizures and posttraumatic epilepsy are not without controversy. This also applies to the evolution of the electroencephalographic characteristics. The study here reported was performed analysing data from patients with posttraumatic epilepsy (N = 205) and data from patients followed-up since trauma and considered as a high risk population for the development of PTE (patients with acute seizures and/or patients with focal lesions--contusion, haematomas or penetrating head injury) (N = 152). Seizure type was associated with age and trauma severity (children, elderly and worst trauma cases present with a higher proportion of partial seizures). Neurological deficit and lesion location were associated with the seizure occurrence. The increased incidence of seizures was found when the most diffused brain dysfunction was combined with neurological deficits. The analysis of sequential EEGs performed at first, at 6th and 12 months post trauma revealed a non-stationary pattern throughout these time periods with EEG focal abnormalities remaining frequent for more than two years after the trauma. Children and old people have a higher proportion of EEG abnormalities with more frequent abnormal generalized activity in children and more frequent abnormal focal EEG activity in the elderly.