Medical Conditions Related to Brain Injury: Seizures
Seizure Medications
Last Updated:
If a person has a seizure immediately after a traumatic brain injury (TBI), the treating physician, usually a neurosurgeon, prescribes an anticonvulsant. Some doctors prescribe it routinely after brain injury even when there’s no seizure, just to lessen the possibility of it happening.
A seizure is a short-circuiting of the brain. Untreated, seizures tend to become more frequent and more severe. The purpose of anticonvulsant such as Tegretol, Depakote, Dilantin and Phenobaritol is to depress the abnormal electrical activity that causes seizures and to prevent subsequent increases in seizure severity.
About two weeks after the brain injury, if the person no longer has seizures, the physician may wean the patient off the anticonvulsant. People who need to be on seizure medication long term are usually those who have seizures more than two weeks post injury and those who’s injury involves a penetrating head injury or a penetrating skull fracture. There is an increased risk of developing seizures that persists for several years after a brain injury.
Seizure medication does affect alertness, cognition and even physical function such as balance and speech. The impact depends on the medication and the dosage required to keep seizures under control. Some new medications such as Keppra (levetiracetam) or Lamictal (lamotrigine) are promising because they do not seem to interfere as much with the thinking process as others.
Finding the right medication at the right dosage for an individual requires working closely with a neurologist through several months of trying and adjusting medication. Some factors that influence the choice of medication include:
- Effectiveness. Because each person assimilates differently, what works for one doesn’t work for everyone. Often a combination of several anticonvulsants is more effective in controlling seizures that one.
- Side effects. Sometimes a specific medication at any level makes the person sick. More often, the dosage required to be effective is too high. For whatever reason, if the person becomes too debilitated to function another medication must be considered.
- Frequency. Multiple daily doses can be problematic for people with brain injury who have trouble tracking time. Time release or drugs that remain in the system longer are best; however not all anti-seizure drugs have those properties.
www.efa.org - Epilepsy Foundation site features definitions, characteristics of types of seizures as well as current research, legislation and resources relating to epilepsy.
www.epilepsyga.org - Epilepsy Foundation of Georgia offers general information on seizures and local resources for support groups, etc.
www.aan.com - Professional site of the American Academy of Neurology
Dr. Weissman is the current Medical Director of Day Rehabilitation and Rehabilitation Services of Children’s Healthcare of Atlanta at Egleston. She serves on the Board of Directors of the Brain Injury Resource Foundation. In addition, she is an Associate Professor of Pediatrics and Neurology at Emory University School of Medicine and a committee member of the American Society for Neurorehabilitation.