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The impact of posttraumatic seizures on 1-year neuropsychological and psychosocial outcome of head injury

  • Alan M. Haltiner (a1), Nancy R. Temkin (a2) (a3), H. Richard Winn (a2) and Sureyya S. Dikmen (a1) (a2) (a4)


This study examined the relationship of posttraumatic seizures and head injury severity to neuropsychological performance and psychosocial functioning in 210 adults who were prospectively followed and assessed 1 year after moderate to severe traumatic head injury. Eighteen percent (n = 38) of the patients experienced 1 or more late seizures (i.e., seizures occurring 8 or more days posttrauma) by the time of the 1-year followup. As expected, the head injured patients who experienced late posttraumatic seizures were those with the most severe head injuries, and they were significantly more impaired on the neuropsychological and psychosocial measures compared to those who remained seizure free. However, after the effects of head injury severity were controlled, there were no significant differences in neuropsychological and psychosocial outcome at 1 year as a function of having seizures. These findings suggest that worse outcomes in patients who develop posttraumatic seizures up to 1 year posttrauma largely reflect the effects of the brain injuries that cause seizures, rather than the effect of seizures. (JINS, 1996, 2, 494–504.)



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Annegers, J.F., Grabow, J.D., Groover, R.V., Laws, E.R., Elveback, L.R., & Kurland, L.T. (1980). Seizures after head trauma: A population study. Neurology, 30, 683689.
Armstrong, K.K., Sahgal, V., Bloch, R., Armstrong, K.J., & Heinemann, A. (1990). Rehabilitation outcomes in patients with posttraumatic epilepsy. Archives of Physical Medicine and Rehabilitation, 71, 156190.
Bennett, T.L. (1987). Post-traumatic epilepsy: Its nature and implications for head injury recovery. Cognitive Rehabilitation, 5, 1418.
Beran, R.G. & Flanagan, P.J. (1987). Psychosocial sequelae of epilepsy: The role of associated cerebral pathology. Epilepsia, 28, 107110.
Caveness, W.F.Meirowsky, A.M., Rish, B.L., Mohr, J.P., Kistler, J.P., Dillon, J.D., & Weiss, G.H. (1979). The nature of posttraumatic epilepsy. Journal of Neurosurgery, 50, 545553.
Dikmen, S.S., Machamer, J.E., Winn, H.R., & Temkin, N.R. (1995a). Neuropsychological outcome at 1-year post head injury. Neuropsychology, 9, 8090.
Dikmen, S. & Reitan, R. (1978). Neuropsychological performance in posttraumatic epilepsy. Epilepsia, 19, 177183.
Dikmen, S.S., Ross, B.L., Machamer, J.E., & Temkin, N.R. (1995b). One year psychosocial outcome in head injury. Journal of the International Neuropsychological Society, 1, 6777.
Dikmen, S.S., Temkin, N.R., Miller, B., Machamer, J., & Winn, H.R. (1991). Neurobehavioral effects of phenytoin prophylaxis of posttraumatic seizures. Journal of the American Medical Association, 265, 12711277.
Dikmen, S.S., Temkin, N., Miller, B., Machamer, J., & Winn, H.R. (1994). Employment following traumatic head injuries. Archives of Neurology, 51, 177186.
Dodrill, C.B. (1978). A neuropsychological battery for epilepsy. Epilepsia, 19, 611623.
Dodrill, C.B. & Wilensky, A.J. (1990). Intellectual impairment as an outcome of status cpilepticus. Neurology, 40 (Suppl. 2), 2327.
Grafman, J., Jonas, B., & Salazar, A. (1992). Epilepsy following penetrating head injury to the frontal lobes: Effects on cognition. In Chauvel, P., Delgado-Escueta, A.V., E., Halgren, & J., Bancaud (Eds.), Advances in Neurology (pp. 369378). New York: Raven Press.
Hoch, D.B., Hill, R.A., & Oas, K.H. (1994). Epilepsy and mental decline. Neurologic Clinics, 12, 101113.
Holmes, G.L. (1991). Do seizures cause brain damage? Epilepsia, 32, S14–S28.
Jennett, B. (1975). Epilepsy after non-missile head injuries (2nd ed.). London: Heinemann.
Jennett, B. & Bond, M. (1975). Assessment of outcome after severe brain damage. Lancet, 1(7905), 480484.
Katz, D. & Alexander, M.P. (1994). Traumatic brain injury: Predicting course of recovery and outcome for patients admitted to rehabilitation. Archives of Neurology, 51, 661670.
Koehler, J. (1994). Risk of late unprovoked seizures in patients with moderate/severe head injuries. Unpublished master's thesis, University of Washington, Seattle, WA.
Levin, H.S., Gary, H.E., Eisenberg, H.M., Ruff, R.M., Barth, J.T., Kreutzer, J., High, W.M., Portman, S., Foulkes, M.A., Jane, J.A., Marmarou, A., & Marshall, L.F. (1990). Neurobehavioral outcome 1 year after severe head injury: Experience of the Traumatic Coma Data Bank. Journal of Neurosurgery, 73, 699709.
Marks, D.A., Kim, J., Spencer, D.D., & Spencer, S.S. (1995). Seizure localization and pathology following head injury in patients with uncontrolled epilepsy. Neurology, 45, 20512057.
Matthews, C.G. & Klove, H. (1967). Differential psychological performances in major motor, psychomotor, and mixed seizure classifications of known and unknown etiology. Epilepsia, 8, 117128.
McLean, A., Dikmen, S., & Temkin, N. (1993). Psychosocial recovery after head injury. Archives of Physical Medicine and Rehabilitation, 74, 10411046.
Reitan, R.M. & Wolfson, D. (1993). The Halstead-Reitan Neuropsychological test battery: Theory and clinical interpretation (2nd ed.). Tucson: Neuropsychology Press.
Ross, B.L., Temkin, N.R., Newell, D., & Dikmen, S.S. (1994). Neuropsychological outcome in relation to head injury severity: Contributions of coma length and focal abnormalities. American Journal of Physical Medicine and Rehabilitation, 73, 341347.
Salazar, A.M., Jabbari, B., Vance, S.C., Grafman, J., Amin, D., & Dillon, J.D. (1985). Epilepsy after penetrating head injury. 1. Clinical correlates: A report of the Vietnam Head Injury Study. Neurology, 35, 14061414.
Smith, K.R., Goulding, P.M., Wilderman, D., Goldfader, P.R., Holterman-Hommes, P., & Wei, F. (1994). Neurobehavioral effects of phenytoin and carbamazepine in patients recovering from brain trauma: A comparative study. Archives of Neurology, 51, 653660.
Teasdale, G. & Jennett, B. (1974). Assessment of coma and impaired consciousness: A practical scale. Lancet, 2(872). 8184.
Temkin, N.R., Dikmen, S.S., Wilensky, A., Keihm, J., Chabal, S., & Winn, H.R. (1990). A randomized, double-blind study of phenytoin for the prevention of post-traumatic seizures. New England Journal of Medicine, 323, 497502.
Tucker, G.J. & Neppe, V.N., (1994). Seizures. In Silver, J.M., Yudofsky, S.C., & Hales, R.E. (Eds.). Neuropsychiatry of traumatic brain injury (pp. 513531). Washington, DC: American Psychiatric Press.
Wechsler, D. (1955). Manual for the Wechsler Adult Intelligence Scale. New York: The Psychological Corp.
Yablon, S.A. (1993). Posttraumatic seizures. Archives of Physical Medicine and Rehabilitation, 74, 9831001.
Young, B., Rapp, R.P., Haack, D., Tibbs, P.A., & Bean, J.R. (1983). Failure of prophylactically administered phenytoin to prevent late posttraumatic seizures. Journal of Neurosurgery, 58, 236241.


The impact of posttraumatic seizures on 1-year neuropsychological and psychosocial outcome of head injury

  • Alan M. Haltiner (a1), Nancy R. Temkin (a2) (a3), H. Richard Winn (a2) and Sureyya S. Dikmen (a1) (a2) (a4)


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