scholarly journals Surgical Outcomes in Post-Traumatic Epilepsy: A Single Institutional Experience

2019 ◽  
Vol 18 (1) ◽  
pp. 12-18 ◽  
Author(s):  
Frederick L Hitti ◽  
Matthew Piazza ◽  
Saurabh Sinha ◽  
Svetlana Kvint ◽  
Eric Hudgins ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Seizure Frequency ◽  
Surgical Outcomes ◽  
Temporal Lobectomy ◽  
Mesial Temporal Sclerosis ◽  
Post Traumatic ◽  
Neocortical Epilepsy ◽  
Post Traumatic Epilepsy ◽  
Traumatic Epilepsy

Abstract BACKGROUND Post-traumatic epilepsy (PTE) is a debilitating sequela of traumatic brain injury (TBI), occurring in up to 20% of severe cases. This entity is generally thought to be more difficult to treat with surgical intervention. OBJECTIVE To detail our experience with the surgical treatment of PTE. METHODS Patients with a history of head injury undergoing surgical treatment for epilepsy were retrospectively enrolled. Engel classification at the last follow-up was used to assess outcome of patients that underwent surgical resection of an epileptic focus. Reduction in seizure frequency was assessed for patients who underwent vagal nerve stimulator (VNS) or responsive neurostimulator (RNS) implantation. RESULTS A total of 23 patients met inclusion criteria. Nineteen (82.6%) had mesial temporal sclerosis, 3 had lesional neocortical epilepsy (13.0%), and 1 had nonlesional neocortical epilepsy (4.3%). Fourteen patients (60.9%) underwent temporal lobectomy (TL), 2 underwent resection of a cortical focus (8.7%), and 7 underwent VNS implantation (30.4%). Three patients underwent RNS implantation after VNS failed to reduce seizure frequency more than 50%. In the patients treated with resection, 11 (68.8%) were Engel I, 3 (18.8%) were Engel II, and 2 (12.5%) were Engel III at follow-up. Average seizure frequency reduction in the VNS group was 30.6% ± 25.6%. RNS patients had reduction of seizure severity but seizure frequency was only reduced 9.6% ± 13.6%. CONCLUSION Surgical outcomes of PTE patients treated with TL were similar to reported surgical outcomes of patients with nontraumatic epilepsy treated with TL. Patients who were not candidates for resection demonstrated variable response rates to VNS or RNS implantation.

Post traumatic epilepsy. An analysis of 12 cases

2008 ◽  
Vol 05 (02) ◽  
pp. 93-94
Author(s):  
KI Mathai ◽  
MS Sasivadanan ◽  
S Sudumbraker ◽  
PK Sahoo
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Neural Circuitry ◽  
Quality Of Control ◽  
Post Traumatic ◽  
Post Traumatic Epilepsy ◽  
Insight Into ◽  
Traumatic Epilepsy

AbstractAn analysis of the mechanism of epilepsy and epileptogenesis after traumatic brain injury will give us an insight into neural circuitry. In a retrospective analysis of 48 cases of moderate and severe traumatic brain injury, who reported for follow up to our centre over a period of two years. Of these, 12 patients with post traumatic epilepsy were identified. The risk factors, EEG patterns and the quality of control were analyzed. The pathophysiology and paradigms of management have been discussed.

Characteristics and surgical outcomes for medial temporal post-traumatic epilepsy

2008 ◽  
Vol 22 (2) ◽  
pp. 224-230 ◽  
Author(s):  
P. Hartzfeld ◽  
K. Elisevich ◽  
M. Pace ◽  
B. Smith ◽  
J. A. Gutierrez
Keyword(s):  
Surgical Outcomes ◽  
Post Traumatic ◽  
Post Traumatic Epilepsy ◽  
Traumatic Epilepsy

Uso de anticonvulsivantes no traumatismo cranioencefálico

2015 ◽  
Vol 23 (1) ◽  
pp. 150-153
Author(s):  
Vinicius Ricieri Ferraz ◽  
Alexandros Theodoros Panagopoulos ◽  
José Carlos Esteves Veiga ◽  
Guilherme Brasileiro de Aguiar
Keyword(s):  
Craniocerebral Trauma ◽  
Post Traumatic ◽  
Post Traumatic Epilepsy ◽  
Traumatic Epilepsy

Objetivo. Verificar as indicações de uso de anticonvulsivantes em pa­cientes vítimas de traumatismo cranioencefálico (TCE), avaliando os malefícios e benefícios do uso de diferentes drogas anticonvulsivan­tes descritas na literatura. Método. Foi realizada revisão de literatu­ra, utilizando as bases de dados MEDLINE e SCIELO, utilizando os termos: “Epilepsia Pós-Traumática”, “Traumatismos Craniocerebrais ”, “Anticonvulsivantes”, “Post-Traumatic Epilepsy”, “Craniocerebral Trauma” e “Anticonvulsants”. Foram incluídos artigos com enfoque tanto no uso profilático quanto terapêutico de drogas anticonvulsi­vantes no TCE. Foram selecionados os artigos mais relevantes entre os anos de 1980 e 2014. Resultados. Vários autores têm estudado o uso de anticonvulsivantes de forma profilática ou terapêutica em vítimas de TCE, demonstrando o risco de desenvolver convulsão pós traumática em relação ao tipo de lesão cerebral apresentada e com a gravidade do trauma. Conclusão. A maior parte dos artigos não demonstra benefício em se realizar profilaxia anticonvulsivante por mais de sete dias após o trauma. Mais estudos randomizados com uma amostra significativa de pacientes poderiam ser conduzidos no intui­to de comparar o efeito de diferentes drogas anticonvulsivantes tanto na profilaxia quanto no tratamento da epilepsia pós traumática e seu impacto na qualidade de vida desses pacientes e também na morbi­mortalidade dos mesmos.

Time Interval Between Traumatic Brain Injury And Post Traumatic Epilepsy

2013 ◽  
Vol 21 (2) ◽  
pp. 222-228
Author(s):  
Daniel Garbin Di Luca ◽  
Glenda Corrêa Borges de Lacerda
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
First Year ◽  
Time Interval ◽  
Partial Seizures ◽  
Complex Partial Seizures ◽  
Post Traumatic ◽  
Faster Development ◽  
Post Traumatic Epilepsy ◽  
Traumatic Epilepsy

Introduction. The estimated time interval in which an individual can develop Post Traumatic Epilepsy (PTE) after a traumatic brain injury (TBI) is not clear. Objective. To assess the possible influence of the clinical features in the time interval between TBI and PTE develop­ment. Method. We analyzed retrospectively 400 medical records from a tertiary Brazilian hospital. We selected and reevaluated 50 patients and data was confronted with the time between TBI and PTE devel­opment by a Kaplan-Meier survival analysis. A Cox-hazard regression was also conducted to define the characteristics that could be involved in the latent period of the PTE development. Results. Patients devel­oped PTE especially in the first year (56%). We found a tendency of a faster development of PTE in patients older than 24 years (P<0.0001) and in men (P=0.03). Complex partial seizures evolving to generalized seizures were predominant in patients after moderate (37.7%) and severe (48.8%) TBIs, and simple partial seizures evolving to general­ized seizures in mild TBIs (45.5%). Conclusions. Our data suggest that the first year after a TBI is the most critical period for PTE de­velopment and those males older than 24 years could have a faster development of PTE.

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