A concussion is a traumatic brain injury (TBI) that can happen after a blow or a jolt to your head. It happens if the impact was strong enough to make your brain move rapidly back and forth inside your skull. This results in chemical changes in your brain that affect its normal function.
There are different grades of concussion severity, and they depend on how much damage your brain sustained during the impact. But, how common is epilepsy after a concussion?
It’s possible to develop seizures and epilepsy (repeated seizures) after a concussion. Seizures can happen right after the injury (early symptoms) or months and even years later (late symptoms). Different factors, such as concussion severity, increase the likelihood of seizures.
Keep reading to learn about the connection between concussion and epilepsy, early and late symptoms of seizures after a concussion, how to treat concussion-related epilepsy, and other useful information.
The connection between concussion and epilepsy
According to the Centers for Disease Control and Prevention (CDC)Trusted Source, among people 15 years or older hospitalized for TBI, around 10 percent will develop epilepsy in the following 3 years. The likelihood of developing seizures and epilepsy is higher if your brain injury is severe. Why does this happen?
Early seizures
Seizures can happen in response to drastic chemical changes in your nerve cells (neurons). Normally, neurons release molecules called neurotransmitters that act as chemical messengers between the cells in your body. They control everything that you feel and do, from your mood to the movement of your muscles.
However, during a concussion, the shaking of your brain in the skull may result in a discharge of neurotransmitters from the neurons in your brain that can lead to a seizure. If a seizure happens within the first week after the head injury, it’s called an early seizure. Most early seizures happen within 24 hours following TBI.
Late seizures and epilepsy
If a seizure happens more than a week after your concussion, it’s called a late seizure. These seizures happen when the injury is more severe and causes more long-lasting or even permanent changes in your brain. For example, death of neurons or changes in connections between neurons. Late seizures are more likely to repeat, causing epilepsy.
Risk factors for seizures after TBI
Risk factors for early seizures after TBI include:
- age less than 5 years
- bleeding in the brain
- penetrating injury (something that breaks your scalp and enters your brain)
- brain swelling
- loss of consciousness or memory loss that last longer than 30 minutes
Risk factors for late seizures after TBI are:
- age over 65 years
- bleeding in the brain
- depressed skull fracture (a fracture that causes your skull to sink into the brain cavity)
- penetrating injury
- brain swelling
- early seizures after TBI
- abnormal electroencephalogram (EEG) reading
Signs of epilepsy after a concussion
Epilepsy that develops after a concussion or another TBI is called post-traumatic epilepsy. Its symptoms and signs depend on the type of seizure. You can have more than one type of seizure.
There are two main groups of seizures: generalized and focal, also known as partial. Generalized seizures affect both sides of the brain, while focal seizures affect one area. According to a recent study, about 73 percent of people with post-traumatic epilepsy have generalized seizures.
There are two main types of generalized seizures:
- absence seizures (“zoning out” for a few seconds)
- tonic-clonic seizures (muscle jerks and spasms, loss of consciousness)
Focal seizures can be:
- simple (or focal aware seizure) — twitching or change in sensation like strange taste or smell
- complex (or focal unaware seizure) — decreased level of consciousness, repetitive movements
- secondary generalized (or focal to bilateral tonic clonic seizure) — a focal seizure that progresses into a generalized seizure
When to get medical attention
If you suspect a concussion in yourself or your loved one, it’s best to see a doctor within 1 to 2 days after the episode. They can help evaluate the severity of the injury.
You should seek emergency care for any of the following symptoms after a brain injury:
- seizures
- slurred speech
- trouble waking up
- confusion or loss of consciousness
- trouble walking or maintaining balance
- bouts of nausea or vomiting
- memory loss
- worsening headache
- penetrating head injury
If more than a week has passed after your concussion and you experience a seizure, make sure to see a neurologist.
How epilepsy is treated after a concussion
The main goal of treatment for post-traumatic epilepsy is to prevent future seizures. Based on your risk factors, your doctor may prescribe anti-epileptic drugs after a concussion to decrease the likelihood of early seizures.
If you begin experiencing late seizures, your doctor may prescribe medications to prevent future episodes. They will determine which medications will be the best for you and how long you will need to take them. Although it’s rare, your seizures may gradually slow down and even stop for good.
If you continue to have seizures despite taking anti-epileptic medications, surgery may also be an option.
Living with post-traumatic epilepsy
Because seizures are unpredictable, there are certain lifestyle adjustments you may need to make:
- Depending on your state, you may need to be seizure-free for 3 to 12 months before you can drive.
- Ask your doctor whether it’s OK for you to swim. If you do swim, always do so with a partner and wear a life jacket.
- Be careful around heat or flames, especially if you have uncontrolled seizures.
- Safety-proof your home to protect from injuries during a seizure (for example, pad sharp corners and use a nonslip carpet).
- Avoid working on ladders or other unprotected heights, especially if you’re alone
The bottom line
Although most people will never have a seizure after a concussion, up to 10 percent can develop epilepsy (repeated seizures).
There are two types of seizures after a brain injury: early and late. Early seizures happen within the first week after a concussion. Late seizures appear after the first week and usually reflect more severe and long-lasting damage.
Any seizures after a brain trauma should be evaluated by a medical professional. Your doctor may prescribe medications to prevent future episodes.
Source: healthline.com, Olga Askinazi, PhD
