Rehab Grand Rounds Fall 2015

This issue presents a case study of traumatic brain injury (TBI) and post-traumatic seizures (PTS), including a discussion of risk factors, recognition, and treatment of seizures after TBI.

Educational objectives:

Upon completion of this activity, participants should be able to:

• Demonstrate understanding of the potential risk factors for seizures after traumatic brain injury
• Discuss different experimental models of traumatic brain injury and their findings related to the proposed relationships between cellular mechanisms and post-traumatic seizures
• Review seizure prophylaxis guidelines after traumatic brain injury
• Review potential treatments for post-traumatic seizures

Reading Resources:

1. CDC 1: Centers for Disease Control and Prevention (2014). Traumatic Brain Injury in the United States: Fact Sheet. Retrieved 2014 from Centers for Disease Control and Prevention. http//www.cdc.gov/traumaticbraininjury/get_the_facts.html
2. CDC 2: Centers for Disease Control and Prevention (2014). Severe Traumatic Brain Injury. Retrieved 2014 from Centers for Disease Control and Prevention. http//www.cdc.gov/TraumaticBrainInjury/severe.html.
3. Englander J, Cifu DX, Diaz-Arrastia R (2014). Seizures After Traumatic Brain Injury. Archives of Physical Medicine and Rehabilitation, 95, 1223-1224.
4. Hesdorffer DC, Benn EKT, Cascino GD, Hauser WA (2009). Is a First Acute Symptomatic Seizure Epilepsy? Mortality and Risk for Recurrent Seizure. Epilepsia, 50 (5): 1102-1108.
5. Fisher RS, Acevedo C, Arzimanoglou A, Bogacz A, Cross JH, Elger CE, Engel Jr. J, Forsgren L, French JA, Glynn M, Hesdorffer DC, Lee BI, Mathern GW, Moshé SL, Perucca E, Scheffer IE, Tomson T, Watanabe M, Wiebe S (2014). A Practical Clinical Definition of Epilepsy. Epilepsia, 55(4): 475-482.
6. Rao VR, Parko KL (2015). Clinical Approach to Posttraumatic Epilepsy. Semin Neurol, 35: 57-63.
7. Annegers JF, Hauser WA, Coan SP, Rocca WA (1998). A Population-Based Study of Seizures After Traumatic Brain Injuries. NEJM, 338: 20-24.
8. Englander J, Bushnik T, Duong TT, Cifu DX, Zafonte R, Wright J, Hughes R, Bergman W (2003). Analyzing Risk Factors for Late Postraumatic Seizures: A Prospective, Multicenter Investigation. Arch Phys Med Rehabil, 84: 365-373.
9. Al-Haddad SA, Kirollos R (2002). A 5-Year Study of the Outcome of Surgically Treated Depressed Skull Fractures. Ann R Coll Surg Engl, 84: 196-200.
10. Frey LC (2003). Epidemiology of Posttraumatic Epilepsy: A Critical Review. Epilepsia, 44 (Suppl. 10): 11-17.

Disclosures: 

Doctors Galang, Ferimer, and Wagner have reported no relevant relationships with any entities producing health care goods or services.

Accreditation Statement:

The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The University of Pittsburgh School of Medicine designates this enduring material for a maximum of .5 AMA PRA Category 1 Credits™. Each physician should only claim credit commensurate with the extent of their participation in the activity. Other health care professionals are awarded (0.05) continuing education units (CEU) which are equivalent to .5 contact hour.

For your credit transcript, please access our website 4 weeks post-completion at http://ccehs.upmc.edu and follow the link to the Credit Transcript page. If you do not provide the last 5 digits of your SSN on the next page you will not be able to access a CME credit transcript. Providing your SSN is voluntary.

Release Date: 8/21/2015 | Last Modified On: 8/21/2015 | Expires: 8/22/2016