Posttraumatic epilepsy.

Posttraumatic epilepsy usually occurs within eight days to five years after the head injury; the interval is shorter than two years in 80% of cases bu t can be as long as 30 years after a severe head injury. The risk of post-t raumatic epilepsy is greatest after a severe head injury with an Intracereb ral hematoma, a subdural hematoma, a hemorrhagic contusion, or clinical neu rological sequelae, Minor head injuries are not associated with a significa ntly increased risk of epilepsy. Patients who develop a seizure shortly aft er a severe or even a moderate head injury have a significantly increased r isk of post-traumatic epilepsy. Prophylactic treatment is not warranted in the absence of an early seizure and does not remove the risk of posttraumat ic epilepsy. Symptomatic treatment is the same as in primary epilepsy, alth ough 25% of cases may prove difficult to treat.