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Return to Seizures After Traumatic Injury Overview

More on Seizures After Traumatic Injury

Seizures After Traumatic Injury

Seizures occur in more than one in five patients during the first week after moderate to severe brain injury and may play a role in the conditions associated with brain injury.

Symptoms

Traditionally, early features of traumatic brain injury observed in the ICU have been described in terms of altered cerebral blood flow, altered brain metabolism and neurochemical excitotoxicity.

Diagnosis

Continuous EEG (electroencephalogram or brain wave test) monitoring has been found to help physicians more quickly and effectively treat patients while reducing length of stay in the intensive care unit.

Voltages in the brain are measured using surface electrodes applied to the scalp. The voltages can be measured while the patient is resting or, in some cases (using special techniques), while the patient is moving. EEG is used for many purposes, including the detection of seizures, analysis of general brain functioning, and measurement of voltages associated with movement or sensation. Between 16 and 40 electrodes are attached to the scalp using temporary glue. The voltages generated by the brain are recorded over 30 minutes or longer.

Early diagnosis of convulsive seizures improves the patient's outcome, and monitoring makes this possible.

A physician trained in interpretation of EEG readings reviews the ongoing EEG activity at the bedside at least three times each day and additionally when informed by the bedside nurse of suspicious EEG activity.

Research

In a recent study, convulsive and non-convulsive seizures occurred in 22% of the patients studied. In more than half the patients, the seizures were non-convulsive and were diagnosed on the basis of EEG studies alone. All of those who displayed "status epilepticus" (frequent, repeated seizures occurring at a rate of more than three per hour) died compared with a only 24% in the non-seizure group.

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