Management of Post-Traumatic Seizures and Epilepsy

Traumatic brain injury (TBI) is the third most common cause of epilepsies and post-traumatic epilepsy accounts for ۴% of all epileptic patients. Over ۲% of patients attend to emergency departments in UK each year with head trauma. In USA more than ۳ billion people suffer a TBI with approximately ۳۰۰.۰۰۰ hospitalizations, ۵۰.۰۰۰ mortality, and ۵۶.۳ billion annual costs. TBI causes both primary and secondary injuries to the brain. Secondary injuries include inflammation, neurodegeneration, post transitional modifications (PTMs) following protein synthesis, mossy fibers sprouting, astrocytes activation and neuronal synchronization, leading to not only post traumatic epilepsy (PTE) but also psychiatric disorders such as anxiety, post-traumatic stress disorder (PTSD) and behavioral disorders as well as neurological disturbances including dementia.Brain injury leads to different types of seizures, treatment of which requires specific attention to their risk rates for developing epilepsy. In this lecture in addition to management of post traumatic seizures and epilepsy, important related issues including risk factors for developing PTE and new prophylactic therapies, targeting cytokines, inflammation mediators, astrocytes and other factors involved in neurodegenerative processes, e.g., ISO۱ (macrophage migration inhibitory factor antagonist), apocynin (NADPH-oxidase inhibitor) minozac (selective inhibitor of proinflammatory cytokine activated glia), rapamycin (mTOR inhibitor) and trametinib (highly specific and potent MEK ۱/۲ inhibitor) will be discussed.