Sancho-Rieger J, Parra-Martínez J
Servicio de Nuerología, Hospital General Universitario de Valencia, Valencia, España.
Rev Neurol. 2002 Sep;35 Suppl 1:S39-42.
Due to the vast number of different circumstances surrounding them, the frequency with which post traumatic epileptic seizures occur varies greatly from study to study. Immediate and early epileptic seizures, within a week of the traumatism having taken place, are usually of little importance as regards the risk of post traumatic seizures. The most important factors governing the presentation of post traumatic seizures have to do with the seriousness of the injury, the extension of the brain tissue that is affected and the penetrating nature of the brain traumatism.
Although antiepileptic medication significantly reduces the risk of early seizures from occurring, a review of well designed clinical trials has found no evidence that these drugs reduce the morbidity and mortality associated with head injuries, or the appearance of late seizures.
由于创伤后癫痫发作所涉及的不同情况数量众多,不同研究中创伤后癫痫发作的发生率差异很大。在创伤发生后一周内出现的即刻和早期癫痫发作,就创伤后癫痫发作的风险而言通常不太重要。决定创伤后癫痫发作表现的最重要因素与损伤的严重程度、受影响的脑组织范围以及脑创伤的穿透性有关。
尽管抗癫痫药物能显著降低早期癫痫发作的风险,但对精心设计的临床试验进行回顾发现,没有证据表明这些药物能降低与头部损伤相关的发病率和死亡率,或减少晚期癫痫发作的出现。