What is a seizure?
A seizure is a burst of electrical activity in the brain that typically affects the way someone acts or appears. Seizures sometimes happen after an acquired and/or traumatic brain injury. Most seizures happen in the first days or weeks after the injury. A seizure after a brain injury is called an early seizure if it happens in the first two to seven days after the injury. It is called a late seizure if the first seizure is more than seven days after the injury. Seizures can also happen months or years later. If someone with a brain injury has one seizure, there is a good chance they will have another seizure at some point. Seizures may be a short-term problem; but for some people they can be a long-term problem.
What do I watch for?
- Unusual movement of the head, body, arms, legs, or eyes. This may include stiffening, jerking, or shaking.
- Not answering when spoken to, staring
- Chewing, lip-smacking, or fumbling movements
- Change in sense of smell, hearing, or taste
- Changes in vision, such as an aura or seeing things that aren’t there
- Suddenly feeling tired or dizzy
- Not being able to speak or understand others
- New outbursts of anger or crying
Who can help?
A neurologist is the doctor who prescribes medicine to keep seizures from happening. Most seizures end by themselves after a few minutes. When a seizure happens, you will want to protect your loved one from getting hurt during the seizure. Sometimes seizures do not end on their own; sometimes they keep happening one after the other. This is called status epilepticus, which can be very dangerous. When this happens, the person needs to go to the hospital right away, so you should call 911.
What medications are used?
Patients with a brain injury usually start seizure medication for the first seven days following an injury. If no seizure occurs in seven days, then the medication is usually stopped because they have not been found to prevent seizures after the first week following injury. Some of these medications can be used for treatment of headaches or agitation that may occur after brain injury. Sedation is a common side effect of these medications. These medications are FDA approved for seizures but have not been specifically studied in persons with DoC.
Common seizure medications include:
- Levetiracetam (Keppra)
- Lacosamide (Vimpat)
- Valproic acid (Depakote)
- Oxcarbazepine (Trileptal)
- Carbamazepine (Tegretol)
- Phenytoin (Dilantin)
- Topiramate (Topamax)
- Lamotrigine (Lamictal)
- Zonisamide (Zonegran)
- Brivaracetam (Briviact)
It is important that these medications be taken around the same time each day. Do not change the dose or discontinue the medication without talking with your physician.
How can I help when my loved one is having a seizure?
- Stay calm.
- Do not hold your family member down or try to stop their movements.
- Loosen anything around the neck that makes it hard for them to breathe.
- Clear anything hard or sharp from the area.
- Put something soft under their head.
- Turn them gently onto the side to keep their airway clear.
- Do not try to force their mouth open.
- Stay with them until the seizure ends.
- Call your loved one's doctor.
Call 911 ...
- if your loved one has trouble breathing during or after a seizure
- if the seizure lasts more than a few minutes
- if a second seizure happens right after the first seizure
- if they have trouble waking up from the seizure
- if they have another seizure without waking up between seizures
Where can I learn more about seizures?
From Craig Hospital
Seizures After Traumatic Brain Injury
From Model Systems Knowledge Translation Center
Troubleshooting & Preventing Seizures (PDF)
From Sheperd Center
Traumatic Brain Injury and Epilepsy
From the Epilepsy Foundation