Epilepsy is a fairly frequent complication in patients with acquired brain injury. In some cases the first epileptic episode may occur months or even years after the brain injury, although in most cases it can be controlled by appropriate drugs. It is necessary to visit the neurologist after a first episode to rule out other factors that may influence the onset of seizures and to choose the appropriate treatment.
Types of seizures
Epileptic seizures may be partial or generalized. Partial seizures begin in a defined area of one hemisphere of the brain, whereas generalized seizures are due to a bilateral discharge in a wide area of the brain. Sometimes seizures with a partial origin end up generalizing in a secondary way. Sometimes this generalization is so early that we only observe this phase of the seizure.
In addition to epilepsy of structural or metabolic cause, such as that found in acquired brain damage, there are genetic epilepsies, whose hereditary predisposition is known, and idiopathic epilepsies, whose characteristics and prognosis are known, although medicine has not yet identified the etiology. In some occasions, in spite of doing the study, we are unable to know its origin, we would be talking about an epilepsy of unknown cause.
As for its diagnosis, the first thing to do is to go to the neurologist’s office when there is a suspicion of suffering a seizure or the disease itself. Knowing the clinical history of each patient is essential for decision making, even more so when dealing with people with acquired brain damage. Tests performed to better establish the characteristics and origin of the seizures include magnetic resonance imaging and electroencephalogram.
Treatment
The treatment of epilepsy distinguishes between prevention and pharmacological treatment. Avoiding intermittent light stimuli in some types of epilepsy, taking care of sleep, and not being reckless in the consumption of alcohol can be basic in avoiding an epileptic seizure. Pharmacological treatment will depend on the patient’s age, side effects and, above all, the type of seizure. With pharmacological therapy, three out of four patients end up controlling their epilepsy, and it is even possible to consider withdrawal of the medication on many occasions, under doctor-patient consensus, between 2 and 5 years free of seizures.