Skip to main content Skip to main navigation menu Skip to site footer

Non-motor seizure diagnosed after mild traumatic brain injury: a case report

  • Drestha Pratita Windriya ,
  • Reryd Arindany Wiryawan ,
  • Wardah Rahmatul Islamiyah ,
  • Abdulloh Machin ,


Abstract

Introduction:  In 10% of head injury cases, nonmotor seizures were detected by electroencephalography (EEG) performed in the acute phase.  Nonmotor seizures are often not diagnosed at the start of treatment because the symptoms are often not recognized by the patient's family or doctor. The incidence of seizures in patients with minor head injuries is very low. From the literature, it was found that the type and severity of the head injury is a significant factors in the incidence of post-traumatic seizure. Thus, in this article, we report a case of nonmotor seizures in a patient after a minor head injury.

Case description: An Indonesian female, 53 years old, complained of sudden silence when speaking after 4 days earlier, she fell and hit her head on the right side. There was no loss of consciousness, headache, vomiting or limb weakness. Complaints of motor seizures and a history of previous seizures were denied. There were no cranium defects, hematomas, or open wounds on examination. The results of laboratory tests and non-contrast head CT scans were expected. On electroencephalography (EEG) examination, epileptiform waves were found in the left temporal region. The patient was given anti-seizure drugs, and complaints improved within 2 days of therapy. It is crucial to carry out an EEG examination in the acute phase of a head injury to exclude the possibility of nonmotor seizures and brain dysfunction, which will be at risk of causing seizures later in life after trauma.        
Conclusion: EEG examination in the acute phase of head injury is used to exclude the possibility of nonmotor seizures and brain dysfunction, which will be at risk of causing seizures later in life after trauma.

Keywords: Brain injury electroencephalography non-motor seizure

References

  1. Majidi S, Makke Y, Ewida A, Sianati B, Qureshi AI, Koubeissi MZ. Prevalence and Risk Factors for Early Seizure in Patients with Traumatic Brain Injury: Analysis from National Trauma Data Bank. Neurocrit Care. 2016;27(1):90–5. Available from: http://dx.doi.org/10.1007/s12028-016-0363-6
  2. Wahyuhadi J, Wicaksono P, Notobroto HB. Clinical Outcome of Patients with Diffuse Axonal Injury Receiving Adrenocorticotropin Analogue at Dr. Soetomo Hospital. Folia Medica Indones. 2018;54(3):222. Available from: http://dx.doi.org/10.20473/fmi.v54i3.10019
  3. Andrade P, Banuelos-Cabrera I, Lapinlampi N, Paananen T, Ciszek R, Ndode-Ekane XE, et al. Acute Non-Convulsive Status Epilepticus after Experimental Traumatic Brain Injury in Rats. J Neurotrauma. 2019/02/25. 2019;36(11):1890–907. Available from: https://pubmed.ncbi.nlm.nih.gov/30543155
  4. Oktavian P, Romdhoni AC, Dewanti L, Fauzi A Al. Clinical and Radiological Study of Patients With Skull Base Fracture After Head Injury. Folia Medica Indones. 2021;57(3):192. Available from: http://dx.doi.org/10.20473/fmi.v57i3.22824
  5. Octaviana F, Harisman J, Wiratman W, Budikayanti A. Altered mental status in moderate-severe traumatic brain injury in Indonesia: the clinical manifestation and EEG features of non-convulsive status epilepticus. Heliyon. 2021;7(9):e08067–e08067. Available from: https://pubmed.ncbi.nlm.nih.gov/34622071
  6. Lee JH, Hur JS, Moon HJ, Kim JH, Kim JH, Kim JH, et al. Nonconvulsive Seizures of Traumatic Brain Injury Patients. Korean J Neurotrauma. 2013;9(2):64. Available from: http://dx.doi.org/10.13004/kjnt.2013.9.2.64
  7. Al Fauzi A, Apriawan T, Ranuh IGMAR, Christi AY, Bajamal AH, Turchan A, et al. Traumatic brain injury in pregnancy: A systematic review of epidemiology, management, and outcome. J Clin Neurosci. 2023;107:106–17. Available from: http://dx.doi.org/10.1016/j.jocn.2022.12.007
  8. Sharma R, Leung WL, Zamani A, O’Brien TJ, Casillas Espinosa PM, Semple BD. Neuroinflammation in Post-Traumatic Epilepsy: Pathophysiology and Tractable Therapeutic Targets. Brain Sci. 2019;9(11):318. Available from: https://pubmed.ncbi.nlm.nih.gov/31717556
  9. Shandra O, Robel S. Inducing Post-Traumatic Epilepsy in a Mouse Model of Repetitive Diffuse Traumatic Brain Injury. J Vis Exp. 2020;(156):10.3791/60360. Available from: https://pubmed.ncbi.nlm.nih.gov/32090988
  10. Gilad R, Boaz M, Sadeh M, Eilam A, Dabby R, Lampl Y. Seizures after Very Mild Head or Spine Trauma. J Neurotrauma. 2013;30(6):469–72. Available from: http://dx.doi.org/10.1089/neu.2012.2625
  11. Goldstein LH, Robinson EJ, Reuber M, Chalder T, Callaghan H, Eastwood C, et al. Characteristics of 698 patients with dissociative seizures: A UK multicenter study. Epilepsia. 2019;60(11):2182–93.
  12. Francis P, Baker GA. Non-epileptic attack disorder (NEAD): a comprehensive review. Seizure. 1999;8(1):53–61. Available from: http://dx.doi.org/10.1053/seiz.1998.0246
  13. Barry E, Krumholz A, Bergey GK, Chatha H, Alemayehu S, Grattan L. Nonepileptic Posttraumatic Seizures. Epilepsia. 1998;39(4):427–31. Available from: http://dx.doi.org/10.1111/j.1528-1157.1998.tb01395.x
  14. Christensen J. Traumatic brain injury: Risks of epilepsy and implications for medicolegal assessment. Epilepsia. 2012;53(SUPPL. 4):43–7.
  15. Pitkänen A, Ekolle Ndode-Ekane X, Lapinlampi N, Puhakka N. Epilepsy biomarkers - Toward etiology and pathology specificity. Neurobiol Dis. 2018/05/18. 2019;123:42–58. Available from: https://pubmed.ncbi.nlm.nih.gov/29782966
  16. Thompson K, Pohlmann-Eden B, Campbell LA, Abel H. Pharmacological treatments for preventing epilepsy following traumatic head injury. Cochrane Database Syst Rev. 2015;2015(8):CD009900–CD009900. Available from: https://pubmed.ncbi.nlm.nih.gov/26259048
  17. Carney N, Totten AM, O’Reilly C, Ullman JS, Hawryluk GWJ, Bell MJ, et al. Guidelines for the Management of Severe Traumatic Brain Injury, Fourth Edition. Neurosurgery. 2017;81(1):E3–4. Available from: http://dx.doi.org/10.1093/neuros/nyx087
  18. Fordington S, Manford M. A review of seizures and epilepsy following traumatic brain injury. J Neurol. 2020;267(10):3105–11. Available from: https://doi.org/10.1007/s00415-020-09926-w

How to Cite

Windriya, D. P., Wiryawan, R. A. ., Islamiyah, W. R. ., & Machin, A. . (2023). Non-motor seizure diagnosed after mild traumatic brain injury: a case report. Bali Medical Journal, 12(2), 1407–1409. https://doi.org/10.15562/bmj.v12i2.4402
ACM ACS APA ABNT Chicago Harvard IEEE MLA Turabian Vancouver
Download Citation
Endnote/Zotero/Mendeley (RIS) BibTeX

HTML
0

Total
0

Share

Search Panel

Drestha Pratita Windriya
Google Scholar
Pubmed
BMJ Journal

Reryd Arindany Wiryawan
Google Scholar
Pubmed
BMJ Journal

Wardah Rahmatul Islamiyah
Google Scholar
Pubmed
BMJ Journal

Abdulloh Machin
Google Scholar
Pubmed
BMJ Journal