Fordington Surina, Manford Mark
University of Cambridge, Cambridge, UK.
Department of Clinical Neuroscience, University of Cambridge, Cambridge, UK.
J Neurol. 2020 Oct;267(10):3105-3111. doi: 10.1007/s00415-020-09926-w. Epub 2020 May 22.
Traumatic brain injury (TBI) is one of the commonest presentations to emergency departments and is associated with seizures carrying different significance at different stages following injury. We describe the epidemiology of early and late seizures following TBI, the significance of intracranial haemorrhage of different types in the risk of later epilepsy and the gaps in current understanding of risk factors contributing to the risk of post-traumatic epilepsy (PTE). The delay from injury to epilepsy presents an opportunity to understand the mechanisms underlying changes in the brain and how they may reveal potential targets for anti-epileptogenic therapy. We review existing treatments, both medical and surgical and conclude that current research is not tailored to differentiate between PTE and other forms of focal epilepsy. Finally, we review the increasing understanding of the frequency and significance of dissociative seizures following mild TBI.
创伤性脑损伤（TBI）是急诊科最常见的病症之一，并且与受伤后不同阶段具有不同意义的癫痫发作相关。我们描述了TBI后早期和晚期癫痫发作的流行病学、不同类型颅内出血在后期癫痫风险中的意义，以及目前对导致创伤后癫痫（PTE）风险的危险因素认识上的差距。从受伤到癫痫发作的延迟为了解大脑变化的潜在机制以及它们如何揭示抗癫痫发生治疗的潜在靶点提供了机会。我们回顾了现有的内科和外科治疗方法，并得出结论，目前的研究并未针对区分PTE与其他形式的局灶性癫痫进行设计。最后，我们回顾了对轻度TBI后分离性癫痫发作的频率和意义的日益深入的理解。
