Understanding Non-Epileptic Seizures After Head Injuries

Understanding Non-Epileptic Seizures After a Head Injury

Experiencing a seizure can be terrifying, especially if you recently suffered a head injury. While post-traumatic seizures sometimes indicate epilepsy, other non-epileptic factors could instead trigger these episodes after brain trauma.

Seizure Causes Following Head Injuries

Seizures arising within days or weeks post-head injury often classify as post-traumatic seizures. Causes relate to direct brain tissue damage from the initial concussion or blow.

But longer-term seizures may relate to secondary brain changes like:

• Scar tissue interfering with signaling
• Chronic inflammation
• Imbalanced neurotransmitters

Rates of post-head injury seizures depend partly on injury severity. While only 1-2% of people with mild concussions experience later seizures, over 25% with penetrating wounds develop them.

Epileptic vs. Non-Epileptic Seizures

Seizures stemming from head trauma may either classify as epileptic or non-epileptic in nature. Determining which type requires conducting tests like:

• EEG monitoring
• CT scans
• MRI imaging
• Blood tests

These help identify whether abnormal electrical activity characteristic of epilepsy occurs in the brain, or if unrelated mechanisms trigger non-epileptic seizures instead.

What are Non-Epileptic Seizures?

When seizure episodes occur without detectable epileptic discharges on EEGs, these classify as non-epileptic. Also called NEAD (non-epileptic attack disorder) or psychogenic seizures, they resemble epileptic attacks.

But rather than faulty brain signaling, root causes may involve:

• Extreme emotional stress reactions
• Mental health disorders like PTSD or anxiety
• Poor sleep habits
• Hormonal fluctuations
• Neurological conditions like migraines

Common Non-Epileptic Seizure Triggers Post-Head Injury

Myriad factors provoke non-epileptic seizures following head trauma or concussions. Some main triggers include:

1. Post-Concussion Syndrome

Lingering post-concussion syndrome affects 10-15% of people after moderate brain injuries, causing issues for months or years post-trauma like:

• Headaches
• Dizziness
• Mental fogginess
• Light and noise sensitivity
• Disordered sleep

Such symptoms overload the nervous system and neural signaling, potentially evoking non-epileptic seizures through pathways presently unknown.

2. PTSD and Severe Anxiety

Surviving any traumatic injury proves stressful. But concussions or accidents causing head trauma elevate Post-Traumatic Stress Disorder risks higher than near-death experiences from other injuries like:

• Gun assaults
• Sexual abuse
• Warzone exposure

Extreme anxiety from recalling the event or ongoing medical issues post-accident may trigger non-epileptic seizures by lowering the brains seizure threshold.

3. Medication Side Effects

Ironically, certain drugs used to manage post-head injury issues could potentially exacerbate seizure risks including:

• Opioid pain relievers
• Antidepressants
• Stimulants
• Sedating antihistamines like Benadryl

Always disclose any new medication reactions like seizure episodes to your doctor immediately.

4. Sleep Disturbances

Disordered sleep commonly follows concussions and TBIs, including problems like:

• Insomnia
• Nightmares
• Restless leg syndrome
• Sleep apnea

Chronic sleep loss stresses the central nervous system, reducing seizure thresholds. This may trigger non-epileptic seizure episodes in predisposed individuals.

5. Emotional Reactions

Bottling up feelings about the injury event or subsequent life changes often backfires. Internalizing anger, grief, resentment, embarrassment or other intense emotions ratchets up internal stress.

This strains the mind-body network until non-epileptic seizures manifest providing a pressure release. Counseling helps prevent this by encouraging healthy emotional processing.

Managing Non-Epileptic Seizures After Brain Injuries

Despite resembling epileptic seizures, non-epileptic episodes likely dont respond to anticonvulsant medications. Because different mechanisms drive these events, tailored management strategies work best.

1. Psychotherapy

Seeing a therapist or counselor trains vital coping strategies for navigating post-accident issues, PTSD, or difficult emotions possibly worsening episodes.

Approaches like cognitive behavioral therapy (CBT), mindfulness meditation, and emotional freedom technique (EFT) tapping help de-escalate stress and anxiety fuelling seizures.

2. Medication Adjustments

Doctors should re-evaluate all current medications after non-epileptic seizures begin, ensuring doses suit your changed physiology post-injury.

Prescriptions most likely needing adjustments include sedative hypnotics, opioid analgesics, stimulant ADHD drugs, and psychiatric medications. But all drugs carry risks warranting review.

3. Better Sleep Strategies

Improving sleep quality minimizes seizure triggers like fatigue, mood changes, and overloaded nervous system signaling.

Tips for restful sleep include:

• Blackout curtains
• Comfortable bedding
• Relaxation exercises
• Soothing music or white noise
• Restricting caffeine past noon

Ask your doctor about safe sleep aid options if insomnia persists despite such efforts.

4. Stress and Emotion Management

Learning constructive ways for expressing emotions helps avoid repressing anger, grief, fear, embarrassment or other tough feelings commonly arising post-injury.

Healthy outlets like journaling, art therapy, support groups or recreation often provide stress relief preventing seizure flare ups.

5. Biofeedback Training

Research indicates biofeedback using EEG neurofeedback effectively reduces non-epileptic seizure frequency over time without medication.

This trains patients to recognize and self-regulate brain wave patterns through relaxation techniques minimizing abnormal signaling triggering seizures.

When to Seek Emergency Care

While generally not medically dangerous, all seizure episodes warrant prompt medical assessment to determine epileptic or non-epileptic status.

Seek emergency assistance if seizures:

• Last over 5 minutes
• Occur back to back
• Involve loss of bladder control
• Cause secondary injuries like head trauma

Calling 911 facilitates rapid treatment and transport to prevent complications like brain damage from oxygen loss during longer attacks.

Working closely with your doctor determines whether post-injury seizures classify as non-epileptic or epileptic, guiding appropriate lifestyle changes and therapy options.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.