scholarly journals Exacerbation of Pre-existing Epilepsy by Mild Head Injury: a Five Patient Series

2004 ◽  
Vol 31 (3) ◽  
pp. 394-397 ◽  
Author(s):  
P.C. Tai ◽  
D.W. Gross
Keyword(s):  
Head Injury ◽  
Temporal Relationship ◽  
Seizure Control ◽  
Head Injuries ◽  
Neurological Deficits ◽  
Mild Head Injury ◽  
Primary Generalized Epilepsy ◽  
Generalized Epilepsy ◽  
One Year ◽  
Patients With Epilepsy

Objective:While the risk of developing seizures following a mild head injury has been reported and is thought to be low, the effect of mild head injury on patients with a pre-existing seizure disorder has not been reported. We present a series of cases where a strong temporal relationship between mild head injury and worsening of seizure frequency was observed.Methods:Five cases were identified and reviewed in detail. Information was derived from clinic and hospital charts with attention to the degree of injury, pre- and postinjury seizure patterns and frequency.Results:One patient has primary generalized epilepsy and four have localization related epilepsy. Prior to the head injury, three of the patients were seizure free (range: two to 24 years). The patients suffered from mild head injuries with no or transient loss of consciousness and no focal neurological deficits. In all cases, the patients experienced a worsening of seizure control within days of the injury. In one case, the patient's seizure pattern returned to baseline one year after the accident, while in the remaining four cases, the patients continue to have medically refractory seizures.Conclusion:A close temporal relationship between mild head injury and a worsening of seizure control was observed in five patients with epilepsy. Although further study is required, this observation suggests that a head injury that would be considered benign in the general population can have serious consequences such as recurrence of seizures and medical intractability in patients with epilepsy.

scholarly journals Chronotypes in Patients with Epilepsy: Does the Type of Epilepsy Make a Difference?

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Hallie Kendis ◽  
Kelly Baron ◽  
Stephan U. Schuele ◽  
Bhavita Patel ◽  
Hrayr Attarian
Keyword(s):  
Seizure Control ◽  
Focal Epilepsy ◽  
Healthy Controls ◽  
Circadian Misalignment ◽  
Age Related ◽  
Primary Generalized Epilepsy ◽  
Generalized Epilepsy ◽  
Patients With Epilepsy ◽  
The Impact ◽  
Related Increase

Circadian rhythms govern all biological functions. Circadian misalignment has a major impact on health. Late chronotype is a risk factor for circadian misalignment which in turn can affect the control of seizures in epilepsy patients. We compared a group of 87 confirmed epilepsy patients regardless of subtypes with age- and sex-matched healthy controls. We compared generalized epilepsy patients with localization related epilepsy patients and with healthy controls. We found that primary generalized epilepsy patients were 5 times more likely to have a late chronotype than healthy controls. We did not find any significant differences between localization related epilepsy patients and healthy controls or between the overall epilepsy cohort and healthy controls. Generalized epilepsy patients are more likely to be evening types as compared to those with focal epilepsy or subjects without epilepsy. Epilepsy patients do not experience the same age related increase in morningness as do age-matched healthy controls. This is important in regard to timing of AED, identifying and preventing sleep deprivation, and integrating chronotype evaluations and chronotherapy in comprehensive epilepsy care. Further studies, using objective phase markers or the impact of chronotherapy on seizure control, are necessary.

Test-Retest Scores for Patients Who Display Neuropsychological Impairment following “Mild Head Injuries” from Mechanical Impacts

1998 ◽  
Vol 86 (3_suppl) ◽  
pp. 1240-1242 ◽  
Author(s):  
Sandra G. Tiller ◽  
M. A. Persinger
Keyword(s):  
Head Injury ◽  
Neuropsychological Tests ◽  
Head Injuries ◽  
Brain Trauma ◽  
Neuropsychological Impairment ◽  
Mild Head Injury ◽  
One Year

A total of 20 patients who had sustained impact of significant mechanical energies to the skull (>40 km/hour) were assessed at Time 1, about one year (68% between 2 mo. and 12 mo.) postincident while Time 2 was about two years later. During Time 1 this group was impaired (proficiency z<−2.00) according to two standardized neuropsychological indices and exhibited abnormally elevated psychometric depression ( z>2.00). There were no statistically significant improvements for the scores between Times 1 and 2 on the Halstead-Reitan Impairment Index, the Memory Quotient, Depression, or an impairment index composed of standardized scores for 31 neuropsychological tests. These results indicated that the presumption of some neuropsychologists that patients with “mild head injury” have fully recovered within one year or will continue to improve after about one year following the incident may not be valid for all patients who sustain such brain trauma.

Assessment of Mild Head Injury Using Measures of Balance and Cognition: A Case Study

1997 ◽  
Vol 6 (3) ◽  
pp. 283-289 ◽  
Author(s):  
Bryan L. Riemann ◽  
Kevin M. Guskiewicz
Keyword(s):  
Head Injury ◽  
Sports Medicine ◽  
Athletic Trainers ◽  
Head Injuries ◽  
Football Player ◽  
Athletic Participation ◽  
Return To Play ◽  
Mild Head Injury ◽  
Collegiate Football

Mild head injury (MHI) represents one of the most challenging neurological pathologies occurring during athletic participation. Athletic trainers and sports medicine personnel are often faced with decisions about the severity of head injury and the timing of an athlete's return to play following MHI. Returning an athlete to competition following MHI too early can be a catastrophic mistake. This case study involves a 20-year-old collegiate football player who sustained three mild head injuries during one season. The case study demonstrates how objective measures of balance and cognition can be used when making decisions about returning an athlete to play following MHI. These measures can be used to supplement the subjective guidelines proposed by many physicians.

Psychiatric Aspects of Self-Induced Epileptic Seizures

2002 ◽  
Vol 36 (4) ◽  
pp. 534-543 ◽  
Author(s):  
Beng-Yeong Ng
Keyword(s):  
Seizure Control ◽  
Epileptic Seizures ◽  
Behavioural Modification ◽  
Intermittent Photic Stimulation ◽  
Contradictory Evidence ◽  
Psychiatric Intervention ◽  
Primary Generalized Epilepsy ◽  
Generalized Epilepsy ◽  
Eye Closure ◽  
Spike Wave

Objective: To review the literature on self-induced epileptic seizures and apply psychiatric knowledge to define possible causes and treatment recommendations. Methods: A review of MEDLINE literature on self-induced epileptic seizures was conducted, followed by cross-referencing with the relevant neurologic, psychiatric and paediatric books and journals. Results: The reported prevalence of self-induction varies depending on the setting. In most instances, self-inducers are people affected by photosensitive primary generalized epilepsy, in whom self-induction is by intermittent photic stimulation or, more rarely, pattern stimulation or eye closure. Self-induced seizures are most commonly absences with spike-wave, though eyelid myoclonia and generalized myoclonic jerks occur. Earlier studies indicate that the majority of self-inducers were of subnormal intelligence but more recent ones indicate that as a group they could not be considered mentally retarded. Monitoring in a well-lit environment is indicated in any therapy-resistant photosensitive patient to determine whether or not selfinduction occurs. Self-induced epilepsy is notoriously resistant to therapy and reasons for this resistance are discussed. An explanatory model for the initiation and maintenance of selfinduction behaviour is also included. Conclusions: It is difficult to determine from published papers just what level of clinical difficulty self-induction of seizures actually posed to the patients and clinicians. In some cases there is contradictory evidence as to the degree of willfulness or self-induction. Self-induced epileptic seizures may be an important aspect of poor seizure control in a subgroup of epilepsy sufferers. These seizures might be modifiable by psychiatric intervention or behavioural modification.

scholarly journals Seizure Exacerbation and Developmental Regression with Carbamazepine

1998 ◽  
Vol 25 (4) ◽  
pp. 287-294 ◽  
Author(s):  
A.N. Prasad ◽  
M. Stefanelli ◽  
L Nagarajan
Keyword(s):  
Seizure Control ◽  
Tertiary Care ◽  
Dramatic Improvement ◽  
Idiopathic Generalized Epilepsy ◽  
Careful Patient ◽  
Developmental Regression ◽  
Group I ◽  
Neurological Exam ◽  
Generalized Epilepsy ◽  
Patients With Epilepsy

ABSTRACT:Background:Unexpected exacerbation of seizures may occur following initiation of treatment with carbamazepine (CBZ). We reviewed the occurrence of such reactions in our patient population at a tertiary care children's hospital.Methods:A retrospective analysis of our clinic database identified 129/691 (18.6%) patients with epilepsy treated with CBZ, as monotherapy. 38/129 children were later switched to another drug. In 11/38 (28.5 %) clinical and/or EEG deterioration was observed. Two patients identified at another institution with similar exacerbation were also included in our analysis. We report on the findings in these 13 cases.Results:Two groups were identified: Group I - 6 patients with normal neurological exam, normal EEG background, and a diagnosis of idiopathic generalized epilepsy. Group II - 7 patients with an abnormal neurological exam and/or abnormal EEG background. Following introduction of CBZ therapy, worsening of preexisting seizures, appearance of new seizure types, behavioral regression, and accompanying EEG deterioration were reported in both groups. Dramatic improvement in seizure control occurred, following withdrawal of CBZ and substitution of another anticonvulsant.Conclusion:Physicians treating epilepsy must be aware that CBZ can exacerbate seizures, and cause developmental regression in children. Careful patient selection, when choosing CBZ as treatment, and prompt recognition of clinical deterioration and intervention, may help avoid or reverse these paradoxical reactions.

scholarly journals Clinical Factors Predictive for Intracranial Hemorrhage in Mild Head Injury

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Chaiyaporn Yuksen ◽  
Yuwares Sittichanbuncha ◽  
Jayanton Patumanond ◽  
Sombat Muengtaweepongsa ◽  
Kasamon Aramvanitch ◽  
...  
Keyword(s):  
Head Injury ◽  
Intracranial Hemorrhage ◽  
Alcohol Intoxication ◽  
Head Injuries ◽  
Loss Of Consciousness ◽  
Mild Head Injury ◽  
Moderate Risk ◽  
Factors Associated ◽  
History Of ◽  
Gcs Score

Patients with mild head injuries, a GCS of 13–15, are at risk for intracranial hemorrhage. Clinical decision is needed to weigh between risks of intracranial hemorrhage and costs of the CT scan of the brain particularly those who are equivocal. This study aimed to find predictors for intracranial hemorrhage in patients with mild head injuries with a moderate risk of intracranial hemorrhage. We defined moderate risk of mild head injury as a GCS score of 13–15 accompanied by at least one symptom such as headache, vomiting, or amnesia or with alcohol intoxication. There were 153 patients who met the study criteria. Eighteen of the patients (11.76%) had intracranial hemorrhage. There were four independent factors associated with intracranial hemorrhage: history of hypertension, headache, loss of consciousness, and baseline GCS. The sensitivity for the presence of intracranial hemorrhage was 100% with the cutoff point for the GCS of 13. In conclusion, the independent factors associated with intracranial hemorrhage in patients with mild head injury who were determined to be at moderate risk for the condition included history of hypertension, headache, loss of consciousness, and baseline GCS score.

scholarly journals Psychiatric morbidity in epilepsy

2017 ◽  
Vol 5 (10) ◽  
pp. 4267 ◽  
Author(s):  
Prem Singh ◽  
Achyut K. Pandey
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Psychiatric Morbidity ◽  
Care Hospital ◽  
Inclusion Criteria ◽  
The Mean ◽  
Antiepileptic Medications ◽  
Generalized Epilepsy ◽  
One Year ◽  
Patients With Epilepsy

Background: Psychiatric morbidity occurs more frequently in patients with epilepsy than in the general population. Routine evaluation and treatment of psychiatric morbidity can be helpful in improving epilepsy care but such data are relatively meagre from developing countries.Methods: The study was conducted in the Epilepsy Clinic of Department of Neurology at a tertiary care hospital over a period of one year.101 patients were included after fulfilling the inclusion criteria. All the patients seeking treatment in the OPD were screened, assessed and then all procedures were fully explained to them. History regarding name, age sex, socio-demographic profile and detailed history regarding seizure disorder was taken from both the patient and the reliable informant. Bengali version of SRQ-24 was used to screen for psychiatric morbidity.Results: One hundred and one patients with epilepsy consisting of 70 men (69.3%) and 31 women (30.7%) were included. Their ages ranged from 15 to 52, the mean age being 26.17 (SD = 7.84). Out of the 101 patients, 65 patients (64.4%) were suffering from partial epilepsies and 36 patients (35.6%) were suffering from generalized epilepsies. 50.49% of the subjects screened positive for psychiatric morbidity. Psychiatric morbidity was higher in unmarried, unemployed males from rural background who were suffering from generalized epilepsy and taking multiple antiepileptic medications. Psychiatric morbidity was statistically significant in people with poor education and those born at home (p<0.05) as compared to well educated, institutionally born persons.Conclusions: 50.49% of the subjects screened positive for psychiatric morbidity.

scholarly journals Case Report: Two cases of rare head injuries from Nepal

F1000Research ◽  
2021 ◽  
Vol 7 ◽  
pp. 1483
Author(s):  
Joe M. Das ◽  
Apar Pokharel ◽  
Rashmi Sapkota ◽  
Manish Mishra ◽  
Ashish Babu Aryal
Keyword(s):  
Head Injury ◽  
Case Reports ◽  
Head Injuries ◽  
Neurological Deficits ◽  
Accidental Injury ◽  
First Case ◽  
Aged Woman ◽  
The Face ◽  
Middle Aged Woman ◽  
The Impact

Background: There are a number of ways in which one can sustain a head injury. Even if you are doing simple household activities or going out for a morning walk, you cannot be sure of what type of injury awaits you. The source of injury may be a pressure cooker whistle acting as a projectile or a hailstone falling from the sky. Such injuries are common in Nepal, considering the socio-demographic and geographic conditions. In this article, we present two such very rare cases of head injury. Case Reports: The first case is a middle-aged woman who sustained an accidental injury to the face associated with fracture of frontal sinus and frontal contusion, following the impact from a high momentum projectile in the form of the pressure regulator of a pressure cooker. She underwent craniotomy and removal of the foreign body. In the second case, an elderly man sustained minor injury to the head following the fall of hail. The abrasions and contusions produced by the hail were managed conservatively. Since he did not have any clinical evidence of head injury, other than multiple abrasions with contusions in the scalp, he did not undergo any imaging studies. He did not have any neurological deficits. The postoperative period was uneventful for the first patient and she was followed up for one month. The second patient was lost to follow-up. Conclusion: Successful management of two very rare cases of head injuries from Nepal are reported. Proper care and maintenance of the house-hold utensils that are constantly used may protect people from head injuries.  Though natural calamities cannot always be avoided, simple measures like using an umbrella while going outdoors may protect individuals from head injuries due to hailstones.

scholarly journals Delayed epidural hematoma after mild head injury

2005 ◽  
Vol 62 (9) ◽  
pp. 679-682
Author(s):  
Danilo Radulovic ◽  
Vesna Janosevic ◽  
Miodrag Rakic ◽  
Branko Djurovic ◽  
Eugen Slavik ◽  
...  
Keyword(s):  
Case Report ◽  
Head Injury ◽  
Early Detection ◽  
Ct Scan ◽  
Neurological Deficit ◽  
Epidural Hematoma ◽  
Head Injuries ◽  
Mild Head Injury ◽  
Intracranial Hematoma ◽  
Surgical Evacuation

Background. Traumatic delayed epidural hematoma (DEH) can be defined as insignificant or not seen on the initial CT scan performed after a trauma but seen on the subsequent CT scan as a ?massive? epidural bleeding. Case report. We presented two cases of traumatic DEH after mild head injury. Both patients were conscious and without neurological deficit on the admission. Initial CT scan did not reveal intracranial hematoma. Repeated CT scan, that was performed after neurological deterioration, revealed epidural hematoma in both cases. The patients were operated with a favorable surgical outcome. Conclusion. Traumatic DEH could occur in the patients with head injuries who were conscious on the admission with a normal initial CT scan finding. Early detection of DEH and an urgent surgical evacuation were essential for a good outcome.

scholarly journals Karakteristik Hasil CT-Scan Kepala pada Penderita Cedera Kepala di Rumah Sakit Dr.H.Abdul Moeloek periode Januari – Desember Tahun 2018

2020 ◽  
Vol 1 (3) ◽  
pp. 177-183
Author(s):  
Muhamad Yunus ◽  
Alfi Wahyudi ◽  
Arti Febriyani H ◽  
Rona Asla Romiza
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Head Injury ◽  
Ct Scan ◽  
Head Injuries ◽  
Univariate Analysis ◽  
Descriptive Study ◽  
Male Gender ◽  
Sampling Techniques ◽  
Mild Head Injury ◽  
Intracranial Lesions

Computerized Tomography (CT) -Scans  examination are the main choice modalities in patients with acute head injuries because they are able to view the entire brain tissues and accurately distinguish the nature and presence of intracranial lesions and Extracranial. This study aim to determine the characteristics of results CT-Scan head on the patient's head injury at Dr.H.Abdul Moeloek Hospital January to December Period 2018. The research is a descriptive study with a crosssectional approach. The samples in this study were all records of medical head injury patients at Dr.H.Abdul Moeloek Hospital in January – December 2018 based on the formula Slovin as many as 182 respondents. The sampling techniques in the study used purposive sampling techniques. Data analysis using univariate analysis. From 182 respondents known prevalence of the age of the patient's head injury is 16-25 years as many as 82 respondents (45.1%), male gender 119 respondents (65.4%), a mild head injury of 105 respondents (57.7%). A normal CT-Scan overview of 99 respondents (54.4%) With a valid description (subarachnoid hemorrhage) as much as 25 respondents (13.7%). Characteristics of results CT-Scan head at the head injury sufferer of most ages 16-25 years, most male gender, most dominant mild head injuries and CT-Scan results most commonly present normal results with description SAH (subarachnoid hemorrhage).

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