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Are seizures common after brain injury?
Seizures are relatively common at various stages following trauma to the brain. Prevention of seizures after moderate and severe TBI (mild TBI does not increase seizure incidence) involves the use of Dilantin (phenytoin) for a 7-day period after the incident. Additional medication has not been shown to be any more effective.
Immediate seizures (within the first 24 hours of injury) are treated with the same 7-day period of Dilantin use for prevention.
Early seizures (24 hours to 1 week after injury) are not always treated similarly; however, in general, they should be treated for 3-6 months with an anticonvulsant (it does not matter which one ... Dilantin, Tegretol, Valproic Acid). Some folks will get a brain wave tracing (EEG) before stopping treatment, but it is not clear what is best.
Late seizures (after 1 week post-injury) should be treated with similar agents for at least 6 months. If the seizures were "status epilepticus" in nature (continuing for more than 2-5 minutes), then treatment should probably extend to a year. A new head CT is appropriate for new "late" seizures (the first one), and an EEG is appropriate before stopping medications.