Neuropsychology and Rehabilitation Psychology Division Department of Physical Medicine and Rehabilitation.



My husband had seizures right around the time of the head trauma. He was put on medication which controlled the seizures. How long will he need to take this medication? Is it possible that he eventually can stop the medication and be seizure-free?

Prophylaxis (prevention) of seizures after moderate and severe TBI (mild TBI does not increase seizure incidence and therefore does not require any prophylaxis) involves the use of Dilantin (phenytoin) for a 7-day period after injury. Additional medication has not been shown to be any more efficacious. "Immediate seizures" (within the first 24 hours of injury) are only treated with the 7-day period of Dilantin that one would use for prophylaxis (they do not increase the risk of "early" or "late" seizures). "Early seizures" (24 hours to 1 week after injury) are not always treated similarly; however, in general, they should be treated for 3-6 months with an anticonvulsant (it does not matter which one ... Dilantin, Tegretol, Valproic Acid). Some folks will get a brain wave tracing (EEG) before stopping treatment, but it is not clear what is best. "Late seizures" (after 1 week post-injury) should be treated with similar agents for at least 6 months. If the seizures were "status epilepticus" in nature (continuing for more than 2-5 minutes), then treatment should probably extend to a year. A new head CT is appropriate for new "late" seizures (the first one), and an EEG is appropriate before stopping medications.

My sister had a severe brain injury due to an assault. I have heard about post-traumatic seizures, and I am worried about her having them. Do all brain injury patients experience post-traumatic seizures? Is this a life-long condition?

Seizures, or "Post-Traumatic Epilepsy," occur in three time frames after traumatic brain injury: Immediate (within the first 24 hours), Early (24 hours to 1 week after injury), and Late (after 1 week post-injury). The incidence of seizures after moderate to severe TBI is approximately 15-20% for the first year (and perhaps 25-30% for 4 years, although this has not been well studied), with most occurring in the "Late" phase. Additionally, of those individuals who develop late seizures, approximately 25% will do so after the first year (and can do so for as long as 4 years post-injury). Things which predispose to early and later seizures are: depressed skull fractures, focal bleeding within the brain tissue with associated swelling, focal neurologic deficits (hemiparesis), and penetrating injuries. Additionally, if you have an "early" seizure you are more likely to have a "late" seizure. An "immediate" seizure does not increase your risk for later seizures. A prior seizure disorder (unrelated to excessive alcohol or drug use and withdrawal) also increases your overall risk for all types of seizures.

Seizures can be manifest in a number of ways. The most common seizure type is labeled a "Complex Partial Seizure," which means involvement (twitching, drawing up) of a part(s) of the body with associated alteration (or loss) in consciousness. It is different from the "Generalized" (Grand Mal) or "Tonic-Clonic Seizure" one typically thinks of, where one has uncontrolled twitching and jerking of the entire body with associated loss of consciousness, incontinence, and a period before and after seizure (pre- and post-ictal phase) of altered consciousness. This "Generalized Seizure" is the second most common type. "Simple Partial Seizures" are the third most common type and are similar to the "Complex Partial Seizure" without any alteration or loss of consciousness. "Abscence Seizures" (Petit Mal) with brief alterations in consciousness are fairly rare after TBI, and can be confused with inattention or hypoarousal.

Patients with seizures are restricted from driving for a period of time (it varies from state to state). Additionally, they should not perform any activity during that time period in which they could injure themselves if they sustained a seizure (power tools, climbing ladders/heights, swimming alone, bathing in a bathtub, etc.) In general, however, seizures do not prevent the individual from leading a full, productive life without functional limitations.

What is the relationship between epilepsy and brain injury? Can a brain injury cause epilepsy in a formerly seizure-free individual?


Brain injury is one of many causes of epilepsy. Epilepsy is not a disease; it is a symptom of a neurologic disorder that affects the brain. The word "epilepsy" comes from a Greek word meaning "to possess, hold or seize" and medically it describes a short-lived burst of energy in the brain . A seizure can strike anyone as a result of a variety of causes, such as a blow to the head, allergic drug reaction, and infections, for example.

There are many different forms of epilepsy, some involving convulsive episodes, while others more subtly affect a person’s ability to sustain attention or create a brief unexplained restlessness and/or experience of feeling "spaced out." Epilepsy can develop immediately after a brain injury or some months or years later, and large numbers of individuals with brain injury never develop epilepsy. The good news is most epilepsy is controllable with medication, and a person can live a normal life. Federal laws prevent discrimination against persons with epilepsy. You may wish to gather more general information about epilepsy by contacting the Epilepsy Foundation of America at 1-800-EFA-1000. Another resource is your local public library or medical library.

12 comments (Add your own)

1. amanda wrote:
My brother had a server brain injury 4 months ago. He has a permanent shunt. Now he just had 3 grand mal in 30 min all lasting a minute. His doctor trying to figure out why . These are his first seizures. His Nero said he had another on th ed or table. More meds had to be given . Is this a bad thing or normal after a tbi?

Wed, September 9, 2015 @ 1:02 AM

2. Ross S. (Eastern Oregon) wrote:
I started having full grand mal seizures a year after my skull was fractured and an artery severed after being assaulted with a shovel to my head. I had surgery that saved my life. I was on keppra for a while but still had seizures, and attempted suicide 3 times. I was switched to lamotrigine. I haven't had a seizure in 10 months, but still have self-destructive thoughts. I also had my drivers license revoked for having a seizure while driving. My neurologist says I'll need the medicine for the rest of my life. Nobody will hire me because of the seizure medicine I take, even though I have a bachelor's degree. I am currently waiting on a disability claim and it's been over 5 years. I am totally dependent on others for survival. I used to be an engineer in a semiconductor mfg facility. I feel helpless and unworthy.

Wed, November 30, 2016 @ 1:49 AM

3. davis wrote:
Ross, hopefully you're still hanging on. My uncle just had a grand mal seizure 3 days ago and he's been in the hospital since. Initially, he was fully sedated because he kept having intense seizures. He was semi conscious yesterday and today, but is still having small seizures every 5 minutes. I started doing more research and came across this blog post and am writing only to spread some positive energy your way.

Thu, January 5, 2017 @ 6:02 PM

4. MasKn wrote:

Sun, January 8, 2017 @ 1:27 PM

5. Alinnnaaa wrote:

Sat, January 14, 2017 @ 1:51 PM

6. FosKn wrote:

Sat, January 14, 2017 @ 11:30 PM

7. DeshawnNor wrote:

Sun, January 22, 2017 @ 5:16 AM

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Mon, January 30, 2017 @ 10:01 AM

9. danielle wrote:
I write as a sign of gratitude to God, i am really happy to be alive today and see the break of another day, I lived and suffered with TBI for a very long time, I was shy and couldnt say it out because of ego issues. I suffered in silence till I was able to get herbal products by DR Jose Alessio, and with his drugs, prayers and instructions I was treated and now i am a happy survivor! pray to God and follow the instructions of Dr Jose, he has the perfect solutions for ailments,Schizophrenia,Traumatic Brain Injuries, Delusions, Brain cancer, Aphasia, Autism, Psychosis and any brain related ailment. Do not wrestle with death on your own, contact him

Tue, February 7, 2017 @ 3:08 PM

10. maria wrote:
My son Michael Mirai has a rare type of epilepsy called Dravet syndrome, also known as Severe Myoclonic Epilepsy of Infancy (SMEI). This is a rare and catastrophic form of intractable epilepsy that begins in infancy. Individuals with SMEI suffer from intellectual disabilities as well as severe behavioral and development delays. All effort made to be sure he did not live his life miserably with deadly disease proof abortive. I have carried him to different Doctors, use different prescription drug all to no avail. Dr. Lawson!!! (with tears of joy) I will forever be indebted to you. Your medicine worked perfectly well and now my son is cured of Epilepsy completely.

Sat, July 1, 2017 @ 10:01 PM

11. sydney wrote:
My son is 5 years old. He suffered from myoclonic seizure for over a year, uncontrollably with meds. When he has one it starts where he rolls his eyes back or his eyes are staring off to nowhere, seeing he arms jerk every single night His breathing gets very shallow and his heart rate speeds up, now his not sleeping. I don't think there's any changing he started experiencing one horrible serious side effect of the medicine. I could not get an appointment with a neurologist for 5 weeks. I was filled with worry. Thank God for a wonderful doctor, i read a testimonial of someone on a website her daughter was cure from seizure using herbal medicine. I called the number that was retain at the website, i explain to doctor Lawson about my son symptom and I ordered his medicine. my son used the medicine for month now, his health has change the meds worked without any trace of side effects. For over 1 year now seizure free if you don't have this herbal product it is available. It works, wonderfully. Call him at (979) 475-5130 or email dr.lawson52@ gmail. com. I'm so grateful that he was able to SURVIVE it

Tue, February 6, 2018 @ 1:27 PM

12. peter emmily wrote:
I myself had epilepsy. Not to this extreme with grand mail seizures daily, but it still affects me in other ways daily. I am on medicine, which has slowly stopped working and I notice my twitches, blank stares, and memory loss (even in the midst of a sentence) starting to return. The side effects of this drug is noticeable and painful to deal with. It is so strong that if a normal person were to take my dose, they will die of an overdose.when i was going through the internet i come across Owens post thanking Dr Lewis hill for curing his seizure problem, and i got the contact of Dr Lewis hill and i quickly contacted him then he made me to know that the medication is 100% cure, and that was how i got the medicine which i used, after which i went for medical test It worked! Over a year now, i have not show any symptoms of seizure and I believe that am cure permanently if you need his help email him on

Thu, June 7, 2018 @ 4:29 PM

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