| Causes | 
Head Trauma: Traumatic brain injury (TBI) is the primary cause, with the risk being higher in more severe injuries such as:
Penetrating head injuriesSevere concussionsContusions and intracranial haemorrhagesSkull fracturesSecondary Factors:
Post-injury infections (e.g., meningitis)Brain swelling (cerebral edema)Secondary brain hypoxia or ischaemia | 
 | Clinical Features | 
Seizure Onset: Seizures can occur immediately after injury (within 24 hours), within a week (early post-traumatic seizures), or after more than a week (late post-traumatic seizures, which are more likely to lead to PTE).Seizure Types:
Focal seizures (with or without impaired awareness)Generalized tonic-clonic seizuresAssociated Symptoms: May include headaches, confusion, memory problems, mood disturbances, and neurological deficits depending on the location of the injury. | 
 | Investigations | 
Neuroimaging:
CT Scan: Initially used to assess for acute injuries such as fractures, haemorrhages, and contusions.MRI: Preferred for detecting chronic structural changes, gliosis, scarring, and subtle injuries not visible on CT.Electroencephalogram (EEG): Used to identify epileptiform activity and to localize seizure foci. Useful for both diagnosis and monitoring.Neuropsychological Testing: May be used to assess cognitive function, especially if there are concerns about memory or other cognitive deficits post-injury.Laboratory Tests: Blood tests to rule out metabolic causes of seizures and monitor for potential side effects of antiepileptic drugs (AEDs). | 
 | Management | 
Acute Seizure Management: 
Stabilize the patient’s airway, breathing, and circulation (ABCs).Administer benzodiazepines (e.g., lorazepam) to control acute seizures.Long-Term Management: 
Antiepileptic Drugs (AEDs): 
First-line treatment to prevent recurrent seizures. Options include levetiracetam, lamotrigine, and phenytoin, among others.Choice of AED may depend on the type of seizures, side effect profile, and patient comorbidities.Monitoring and Follow-Up: Regular follow-up to monitor seizure control, medication side effects, and adjust treatment as necessary.Surgical Intervention: 
Considered for patients with drug-resistant epilepsy, particularly when seizures are localized to a specific area of the brain.Options include resection of the epileptic focus or vagus nerve stimulation (VNS).Rehabilitation: 
Physical therapy, occupational therapy, and cognitive rehabilitation to address deficits caused by the initial injury and seizures.Patient Education: 
Educate the patient and family about seizure precautions, medication adherence, and lifestyle modifications to reduce seizure triggers. |