Posttraumatic epilepsy: The endophenotypes of a human model of epileptogenesis

Ramon Diaz-Arrastia, Mark A. Agostini, Christopher J. Madden, Paul C. Van Ness

Research output: Contribution to journalArticle

57 Citations (Scopus)

Abstract

Posttraumatic epilepsy is a common complication of traumatic brain injury (TBI), occurring in up to 15-20% of patients with severe brain trauma. Trauma accounts for approximately 5% of chronic epilepsy in the community. Because it is a common condition, and because of the relatively short latency period between injury and onset of chronic seizures, posttraumatic epilepsy represents a good model to test antiepileptogenic therapies. However, several well-conducted clinical trials have failed to demonstrate antiepileptogenic efficacy for several common anticonvulsants. Posttraumatic epilepsy can arise through a number of mechanisms, which often coexist within a single patient. Penetrating brain injury produces a cicatrix in the cortex and is associated with a risk of posttraumatic epilepsy of approximately 50%, whereas nonpenetrating head injury may produce focal contusions and intracranial hemorrhages, and is associated with a risk of posttraumatic epilepsy of up to 30%. Furthermore, closed head injury often produces diffuse concussive injury, with shearing of axons and selective damage to vulnerable brain regions, such as the hippocampus. The clinical, neurophysiologic, imaging, and neuropathologic features or epileptogenicity differ between these alternate mechanisms. It is likely that better understanding of the subtypes of epilepsy resulting from brain trauma will be required to successfully identify antiepileptogenic therapies.

Original languageEnglish (US)
Pages (from-to)14-20
Number of pages7
JournalEpilepsia
Volume50
Issue numberSUPPL. 2
DOIs
StatePublished - Feb 2009

Fingerprint

Endophenotypes
Epilepsy
Closed Head Injuries
Wounds and Injuries
Penetrating Head Injuries
Intracranial Hemorrhages
Contusions
Anticonvulsants
Cicatrix
Axons
Hippocampus
Seizures
Clinical Trials
Brain
Therapeutics

Keywords

  • Diffusion tensor imaging
  • Magnetic resonance imaging
  • Neuropathology of epilepsy
  • Video-EEG monitoring

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Posttraumatic epilepsy : The endophenotypes of a human model of epileptogenesis. / Diaz-Arrastia, Ramon; Agostini, Mark A.; Madden, Christopher J.; Van Ness, Paul C.

In: Epilepsia, Vol. 50, No. SUPPL. 2, 02.2009, p. 14-20.

Research output: Contribution to journalArticle

Diaz-Arrastia, Ramon ; Agostini, Mark A. ; Madden, Christopher J. ; Van Ness, Paul C. / Posttraumatic epilepsy : The endophenotypes of a human model of epileptogenesis. In: Epilepsia. 2009 ; Vol. 50, No. SUPPL. 2. pp. 14-20.
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