Evaluation of Seizure-like Episodes in Survivors of Moderate and Severe Traumatic Brain Injury

Hudak, Anne M.; Trivedi, Kavita; Harper, Caryn R.; Booker, Kimberly W.; Caesar, Rajani R.; Agostini, Mark; Ness, Paul C. Van; Diaz‐Arrastia, Ramon

doi:10.1097/00001199-200407000-00003

Cited by 78 publications

(53 citation statements)

References 18 publications

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“…The comparison of neuropathologic alterations between mice and humans with post-traumatic epilepsy (PTE) is difficult, as very few studies have specifically addressed the severity and extent of pathology in human PTE. It has been shown that approximately 53% of patients with posttraumatic temporal lobe epilepsy (TLE) have mesial temporal lobe sclerosis on magnetic resonance imaging (Hudak et al, 2004) that extends bilaterally in some patients (Diaz-Arrastia et al, 2000). Mathern and colleagues (1995) demonstrated a 50-70% loss of principal cells in all hippocampal subfields in patients with drug-refractory TLE.…”

Section: Post-traumatic Epileptogenesis In the Mouse 807mentioning

confidence: 99%

Development of Post-Traumatic Epilepsy after Controlled Cortical Impact and Lateral Fluid-Percussion-Induced Brain Injury in the Mouse

Bolkvadze

Pitkänen

2012

Journal of Neurotrauma

169

142

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The present study investigated the development of hyperexcitability and epilepsy in mice with traumatic brain injury (TBI) induced by controlled cortical impact (CCI) or lateral fluid-percussion injury (FPI), which are the two most commonly used experimental models of human TBI in rodents. TBI was induced with CCI to 50 (14 controls) and with lateral FPI to 45 (15 controls) C57BL/6S adult male mice. The animals were followed-up for 9 months, including three 2-week periods of continuous video-electroencephalographic (EEG) monitoring, and a seizure susceptibility test with pentylenetetrazol (PTZ). In the end, the animals were perfusion-fixed for histology. The experiment included two independent cohorts of animals. Late post-traumatic spontaneous electrographic seizures were detected in 9% of mice after CCI and 3% after lateral FPI. Eighty-two percent of mice after CCI and 71% after lateral FPI had spontaneous epileptiform spiking on EEG. In addition, 58% of mice with lateral FPI showed spontaneous epileptiform discharges. A PTZ test demonstrated increased seizure susceptibility in the majority of mice in both models, compared to control mice. There was no further progression in the occurrence of epilepsy or epileptiform spiking when follow-up was extended from 6 to 9 months. The severity of cortical or hippocampal damage did not differentiate mice with or without epileptiform activity in either model. Finally, two independent series of experiments in both injury models provided comparable data demonstrating reproducibility of the modeling. These data show that different types of impact can trigger epileptogenesis in mice. Even though the frequency of spontaneous seizures in C57BL/6S mice is low, a large majority of animals develop hyperexcitability.

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Section: Post-traumatic Epileptogenesis In the Mouse 807mentioning

confidence: 99%

Development of Post-Traumatic Epilepsy after Controlled Cortical Impact and Lateral Fluid-Percussion-Induced Brain Injury in the Mouse

Bolkvadze

Pitkänen

2012

Journal of Neurotrauma

169

142

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“…A robust and replicated finding is that about 30% of patients seen at epilepsy centers for refractory seizures do not have epilepsy [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17]. Remarkably, the proportion of patients misdiagnosed is also similar in patients diagnosed as having posttraumatic epilepsy [18], patients referred directly (without EEG-video monitoring) for vagus nerve stimulation [19] and in patients awarded a ‘seizure alert dog’ [20]. This is a serious problem because the misdiagnosis of epilepsy has multiple consequences [21,22,23].…”

Section: Introductionmentioning

confidence: 99%

Errors in EEG Interpretation and Misdiagnosis of Epilepsy

2008

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Background/Aims: The overinterpretation of EEGs is common and is an important contributor to the misdiagnosis of epilepsy. We reviewed our experience in order to clarify which EEG patterns are commonly overread as epileptiform. Methods: We identified patients who were seen at our epilepsy clinic and were ultimately diagnosed as having conditions other than epilepsy. We selected those who had previously had an EEG read as showing epileptiform discharges and whose EEG was available for our own re-review. Results: 37 patients met the above criteria. Eventual diagnoses were psychogenic nonepileptic seizures (10), syncope (7), other miscellaneous diagnoses (5) and unexplained nonspecific symptoms (15). None of the EEGs had epileptiform discharges. The descriptions of the abnormalities included ‘temporal sharp waves’ in 30, ‘frontal sharp waves’ in 2 and ‘generalized spike-wave complexes’ in 2. Three had no reports available to identify the alleged abnormality. The benign patterns mistaken for temporal (30) and frontal (2) sharp waves were simple fluctuations of background activity with temporal phase reversals. Conclusions: By far the most common patterns overread as epileptiform are nonspecific fluctuations of background in the temporal regions, which are misread as temporal sharp waves.

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“…In one study, the frequency of psychogenic seizures in patients diagnosed with "pharmacoresistant PTE" reached 30% [7]. There is evidence that the risk of developing psychogeni c attack s is lightweight head injury [8], while the likelihood of epilepsy increases with increasing severity of injury.…”

Section: Clinical Datamentioning

confidence: 99%

Diagnosis and Treatment of Posttraumatic Epilepsy

Kadirovna¹,

Tadjiyevna²,

Kadirovich³

2018

J. res. health sci.

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Both neurologists and psychiatrists often diagnose posttraumatic epilepsy (PTE). This is due to the high rate of craniocerebral trauma (CCT), especially mild; in a patient with a first epileptic seizure, the presence of a history of CCT often leads to an incorrect diagnosis of PTE and inadequate treatment. The article presents our own data and literature review concerning the diagnosis and treatment of PTE.

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Evaluation of Seizure-like Episodes in Survivors of Moderate and Severe Traumatic Brain Injury

Cited by 78 publications

References 18 publications

Development of Post-Traumatic Epilepsy after Controlled Cortical Impact and Lateral Fluid-Percussion-Induced Brain Injury in the Mouse

Development of Post-Traumatic Epilepsy after Controlled Cortical Impact and Lateral Fluid-Percussion-Induced Brain Injury in the Mouse

Errors in EEG Interpretation and Misdiagnosis of Epilepsy

Diagnosis and Treatment of Posttraumatic Epilepsy

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