Medico-Legal Perspectives on Post-Traumatic Epilepsy
By Dr Peter Cleland, Consultant Neurologist
In conjunction with National Epilepsy week 2022 I have been asked to pen the following article regarding epilepsy and medico-legal.
In medico-legal practice involving head injury, experts are often asked to give an assessment of the risk of post-traumatic seizures. In this article I will discuss this issue as well as giving some illustrative examples.
Epilepsy is a common condition with a lifetime risk of around 4%. There is, therefore, a background risk which is increased by a positive family history, certain drugs (such as anti-depressants), excessive alcohol intake or any insult to the brain, such as head injury, brain tumour, intracranial infection or conditions such as multiple sclerosis.
Alcohol is interesting in that in the acute situation alcohol will act as an anti-convulsant but, as the level drops, it makes the brain more prone to seizures. This is the reason why admissions with seizures tend to occur over the weekend following binge drinking on Fridays and Saturdays. Ultimately alcohol damages the brain and nervous system and people with chronic large alcohol intake develop seizures unrelated to acute alcohol binges.