Posttraumatic seizures

1. What are two kinds of posttraumatic seizures (PTS)? Which kind is more common?
2. How are PTS divided by their time post-injury? What kind has the worst prognosis? When do most PTS occur?
3. What are risk factures associated with late PTS?
4. How is PTS diagnosed?

Answers:
1. Generalized (grand mal and tonic clonic) and partial (simple if conscious, complex if not). Partial are more common.
2. Immediate PTS is within 24 hrs, early PTS is within first week, late PTS is after the first week. Early PTS is associated with the highest risk of late PTS. MOst PTS occur 1-3 months post injury.
3. Penetrating head injury, intracranial hematoma, early seizures, depressed skull fracture, prolonged coma, PTA. Less important risk factors are dural tearing, foreign bodies, aphasia, hemiplegia, age, alcohol abuse, tricyclic antidepressants.
4. Clinically, EEG, prolactin level (increased prolactin confirms seizure, but normal does not exclude seizure).