Department of Neurology

Head injury and seizures

Q: My wife, 24, passed out last week, causing a concussion and was taken to the emergency room. After 2 other spells that turned out to be seizures, she was given an EEG and determined to have " a predisposition for having seizures" since she was born. With an official diagnosis of new onset seizure disorder, she is on 300 mg of Dilantin a day, at least until a follow-up appointment with her neurologist. My questions are: could a concussion have caused seizures? what is the difference between grand mal seizure disorder and epilepsy?

thank you.

A: A strong blow to the head can cause a seizure (concussive seizure) that occurs at the time or just after the head injury. A head injury can also cause later epilepsy (post-traumatic epilepsy). While I cannot comment on your wife's EEG, there are certain patterns indicate a tendency for epilepsy, and this may be what your physicians are referring to. A seizure disorder means that a person has seizures. Therefore epilepsy is a seizure disorder. However, epilepsy also means that seizures recur under usual conditions, and thus, not all seizure disorders are epilepsy. For example, some people have seizures with low blood sugar due to insulin.

The term, "grand mal" is outdated. It refers to what are now known as tonic-clonic seizures, which consist of a rigid phase followed by jerking of extremities.

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