Seizure Question
 

Hi,

Having got what I can only assume was a concussion roughly six weeks ago, I have (naturally) begun reading more on the subject; specifically, I came upon a few articles regarding seizures. Does anyone have any knowledge concerning realistic numbers of the odds of incurring epilepsy post-concussion? A Stanford site seems to suggest that only a dramatic increase in likely occurrence (15-30%) triggers when the injury sustained was 'severe'- which they say, involves a loss of consciousness, amnesia, or 'bleeding around the brain'. The latter seems like it would be difficult to diagnose if you didn't get a scan in limited time frame. Anyway, would appreciate any answers!

Pancake

Pancake,

Welcome to NeuroTalk.

First, seizures related to a brain injury are not usually considered epileptic. They would more commonly be called trauma induced seizures. The seizures may be categorized the same as epileptic seizures. Often, they do not show up on an EEG.

Why do you ask ?

Do you think you are experiencing seizures ?

Or are you just anxious about the risk of epilepsy ?

Hi Mark,

I'm mainly concerned that there is some *significant* risk now that the injury has occurred. The Stanford article I mentioned above (no links-new user- eh..) had me concerned at, 'internal bleeding', which seems very hard to determine if not caught in time (which overwhelmingly is not).

So it's really just to get a better idea to know some general metric of possibility, if such a thing even exists.

Welcome to the NeuroTalk Support groups.

I'm just wondering if you were assessed in a hospital setting or by a doctor immediately after your head injury?

If internal bleeding is not caught in time by imaging, then yes, it will be hard to determine is it ever happened. But, if there are no symptoms that suggest a bleed, there is nothing to worry about. The ER concern about bleeds is related to discharging the patient with a condition than may get worse in the next 24 to 48 hours. It has more to do with the hospital's liability risk in that they take a CT Scan image, just in case.

But, bleeds often do not even show up in the first few hours so the more important issue is being aware of any symptoms that develop over the next 48 hours or so.

At six weeks post injury, you are long past any risk.

Are you struggling with any symptoms ?

Re Lara, no, have not yet seen a doc; obviously I know that is by far the best option, but insurance coverage recently has become a problem.

Mark-- I was not sure if not caught via MRI/CT how such a thing would even be traceable, but as I said, was initially concerned regarding that Stanford site I viewed- the 15-30% increase number seemed obviously concerning, and I wasn't sure what constituted a 'bleed'. Thanks.

Pancake

Most doctors are grossly ill-equipped to properly diagnose and treat concussions. Plus, there is very little that can be done for most PCS patients. You are long past any critical time period.

You have not answered as to whether you are having any prolonged symptoms. Unless you are having symptoms, there is nothing to diagnose. Seeing a doctor now would likely be a waste of time and money.

I think I found the article.

http://neurology.stanford.edu/epilep...deos/e_12.html

It says

"Mild head trauma, with loss of consciousness for less than 30 minutes, is associated with barely increased risk of developing epilepsy compared to the general population.

Severe head trauma can be defined as either loss of consciousness or amnesia for greater than a day or internal bleeding in or around the brain. Severe head trauma leads to epilepsy in about 15% of adults and about 30% of children. Injuries with actual penetration of the brain, like a bullet wound, are even more likely to cause epilepsy, about to 25 to 50% of the time. "

You did not suffer an injury like referenced in the second paragraph. If you had, the seizures would be just a miniscule part of your list of symptoms. Those patients are usually admitted to the hospital for observation and treatment.

You likely fit into the first paragraph. You are at "barely increased risk of developing epilepsy compared to the general population."

Mark,

Yep, that's the article- because I did not experience the loss of consciousness or amnesia, I figured it was then a matter of investigating if I had potentially had an internal bleed. Also, I read recently where you mentioned that a loss of consciousness, if within a certain window, has no meaningful placeholder for how severe the injury was, or also on recovery, which seemed almost to conflict with that bit of information in the article.

My symptoms are few, but I do have some-- dizziness if I move around too much, or too strenuously, occasional brain 'fog', meaning it's harder to form sentences as well when speaking. I also had a few migraines which are unusual for me the first three weeks.

Actually, if you read the article, it comments about LOC for more or less than 30 minutes. Less than 30 minutes LOC to no LOC has little direct relation to length of recovery and severity of injury. There are plenty who never lost consciousness who have a more severe injury than those who has 20 minutes LOC. 30 minutes was just used statistically. It is not a hard and fast number.

It sounds like you may be a bit anxious. Your concern about your risks is a good indicator of anxiety. Anxiety is not good for recovery. Your symptoms do not indicate any level of risk for a bleed or other serious condition. I suggest that you accept that you are not at risk and thus reduce your anxiety. Please try to accept that what you are experiencing is very normal. Focusing on getting quiet rest meaning low stress and minimal sensory stimulation with just enough physical activity to keep good blood flow going will be your best bet.

The fact that your migraines only lasted three weeks means you are progressing in your recovery. Be patient and your recovery should continue.

My best to you.