Post-traumatic epilepsy: clinical, neurophysiological and neuroimaging study

ABSTRACT

Post-traumatic epilepsy [PTE] is a recurrent seizure disorder due to traumatic injury of the brain. There is controversy regarding the precise mechanism by which epilepsy may results from traumatic brain injury. Mesial temporal lobe sclerosis [MTS] is reported as a major risk factor for intractability of posttraumatic epilepsy. We aimed from this work to revise patients with post-traumatic epilepsy, to define risk factors, and assess the clinical, neurophysiological and neuroradiological characteristics. The frequency of mesial temporal epilepsy in contrast to neocortical epilepsy was also assessed in these patients. Twenty- three patients with post-traumatic epilepsy were included in this study. Clinical assessment, video EEG monitoring and MRI brain results were reviewed. We found that 14 patients [60.9%] with neocortical epilepsy [NCE], 8 patients [34.8%] of them had their trauma below or equal to 10 years and 6 patients [26.1%] had their trauma above 10 years old. We found also 8 patients [34.8%] with mesial temporal epilepsy [MTE], 5 patients [21.8%] had their trauma below or equal to 10 years and 3 patients [13%] had their trauma above 10 years. There was one patient [4.3%] with mixed neocorical and mesial temporal epilepsy. Of these patients, 6 had temporal lobectomy with successful post-operative results and the diagnosis of mesial temporal sclerosis was pathologically definite in 5 patients. We concluded that MTS could occur in patients with PTE in young or old ages. Detection of MTS is mandatory for all patients with PTE as resective surgeries of these patients gave a good outcome for the control of their intractable epilepsy