Psychiatric aspects of posttraumatic epilepsy: A still unexplored area

Abstract

Traumatic brain injury (TBI) represents one of the most common causes of death and disability in young people and post-traumatic epilepsy (PTE) accounts for 10% to 20% of all symptomatic epilepsies. However, PTE is still a relatively underappreciated condition. This paper is aimed at reviewing current knowledge about psychiatric comorbidities of PTE, looking in particular at the nature of the relationship between traumatic brain injury, psychiatric problems and epilepsy, at the phenomenology of psychiatric disorders in PTE and how to manage them. Data on psychiatric comorbidities of PTE are almost non-existing and this is a paradox considering that TBI itself is burdened by a number of cognitive and psychiatric sequalae which can profoundly affect the everyday life of these patients. Preliminary data seem to suggest that the bidirectional relationship between epilepsy and psychiatric disorders is maintained in TBI and people with a psychiatric condition at the time of the TBI, or as a consequence of it, are at increased risk of developing PTE and vice versa. However, a number of questions are still unanswered concerning the genetic and environmental contributors, the phenomenology of psychiatric disorders in PTE and how to prevent and address them properly. Further research in this area is urgently needed in order to provide the best possible care to people with PTE.