Clinical Approach to Posttraumatic Epilepsy
Open accessAbstract
Traumatic brain injury (TBI) is one of the most common causes of acquired epilepsy, and posttraumatic epilepsy (PTE) results in significant somatic and psychosocial morbidity. The risk of developing PTE relates directly to TBI severity, but the latency to first seizure can be decades after the inciting trauma. Given this "silent period," much work has focused on identification of molecular and radiographic biomarkers for risk stratification and on development of therapies to prevent epileptogenesis. Clinical management requires vigilant neurologic surveillance and recognition of the heterogeneous endophenotypes associated with PTE. Appropriate treatment of patients who have or are at risk for seizures varies as a function of time after TBI, and the clinician's armamentarium includes an ever-expanding diversity of pharmacological and surgical options. Most recently, neuromodulation with implantable devices has emerged as a promising therapeutic strategy for some patients with refractory PTE. Here, we review the epidemiology, diagnostic considerations, and treatment options for PTE and develop a roadmap for providers encountering this challenging clinical entity.
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Possible latencies from TBI to development of PTE vary greatly, from hours or days to months or years after the initial injury.
“Possible latencies from the time of TBI to the development of PTE also vary greatly; this can be hours, days, or as remote as months or years after the initial injury [10,11].”
From Impact of a Prison-Based Religious Program on Mental Health State and Aggression Level Among Female Inmates (2019) · cites this paper as [10]
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Flagged first, then by citations
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Physical Activity in Patients With Epilepsy: A Risk Factor or a Healthy Habit?
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Epilepsy caused by an unrecognized pencil lead misdiagnosed as intracerebral cavernous malformation
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Hemispherotomy for Pediatric Post-Traumatic Epilepsy
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Epileptic and Nonepileptic Seizures after Traumatic Brain Injury
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Idiopathic Intracranial Hypertension (Pseudotumor Cerebri)
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Idiopathic Intracranial Hypertension (Pseudotumor Cerebri)
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Neurochemical Aspects of Traumatic Brain Injury
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Mandelka, L., Strzelczyk, A., Willems, L. M., Funke, M., Reitz, S. C., Czabanka, M., Grefkes, C., Marzi, İ., Schindler, C. R., Bohmann, F. O., et al. (2025) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2025.110798
Posttraumatic epilepsy: Pathophysiology, clinical characteristics and disease within lifespan
Stefan, H., & Hammen, T. (2026) · Seizure · doi:10.1016/j.seizure.2026.07.016
- Authors
- Parko, K., & Rao, V.
- Affiliations
- San Francisco VA Medical Center (US)
- University of California, San Francisco (US)
- Corresponding author
- Rao, Vikram
- ORCID
- Rao, Vikram
- Venue
- Seminars in Neurology
- Publisher
- Georg Thieme Verlag KG
- Published
- 2015-02-25
- Volume
- 35
- Issue
- 01
- Pages
- 057-063
- ISSN
- 0271-8235 (ISSN-L)
- 1098-9021
- OpenAlex
- W2046279217
- Cited by
- 49
- References
- 127
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 3 · 2023: 4 · 2022: 11 · 2021: 3 · 2020: 3 · 2019: 4 · 2018: 5 · 2017: 5 · 2016: 3 · 2015: 1
- FWCI
- 0.64
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Seminars in Neurology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Epilepsy research and treatment
- Health Sciences › Medicine › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Keywords
- post-traumatic epilepsy, traumatic brain injury, acquired epilepsy, epileptogenesis, risk stratification, biomarkers, endophenotypes, antiepileptic drugs, epilepsy surgery, neuromodulation, biomedical implants, drug-resistant epilepsy, epilepsy treatment
- MeSH terms
- Brain Injuries, Epilepsy, Post-Traumatic, Humans, Disease Management
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