title: Nonepileptic posttraumatic seizures.
abstract: OBJECTIVE
  Epileptic posttraumatic seizures (PTSs) are a well-recognized consequence of head injury (HI), but HI and nonepileptic seizures (NESs) have not been related. We describe a significant subset of patients with NESs who had their seizures attributed to HI.
  
  
  METHODS
  We reviewed the records of all patients diagnosed with NES at the University of Maryland Medical Center over a 6-year period (1989-1995) and selected patients with seizures attributed to a head injury occurring < or =3 years before the onset of their seizures.
  
  
  RESULTS
  Of 157 patients with video-EEG confirmed NES, 37 (24%) had the onset of their seizures attributed to an HI. Their average age was 34 years (range, 15-56 years); 68% were women. Nonepileptic PTS usually developed within the first year after HI (89%). Convulsive symptoms were present in 54%. Whereas epileptic PTSs characteristically follow severe HI, the majority (78%) of our patients with nonepileptic PTSs sustained only mild HI. Before their HI, 76% of our patients were employed, working in the home, or students, but only 11% could continue those activities after developing nonepileptic PTSs.
  
  
  CONCLUSIONS
  Nonepileptic PTSs are frequently mistaken for epileptic PTSs and result in serious disability. The misdiagnosis of nonepileptic PTSs leads to ineffective and inappropriate treatment. Patients with intractable seizures after HIs, particularly mild HIs, should be carefully evaluated for NESs.
authors.affiliation: The Maryland Epilepsy Center and the Department of Neurology, University of Maryland School of Medicine, Baltimore, USA.
authors.forename: E
authors.initials: E
authors.lastname: Barry
authors.forename: A
authors.initials: A
authors.lastname: Krumholz
authors.forename: G K
authors.initials: GK
authors.lastname: Bergey
authors.forename: H
authors.initials: H
authors.lastname: Chatha
authors.forename: S
authors.initials: S
authors.lastname: Alemayehu
authors.forename: L
authors.initials: L
authors.lastname: Grattan
mesh_terms: D000293:Adolescent; D000328:Adult; D015897:Comorbidity; D006259:Craniocerebral Trauma / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D003937:Diagnosis, Differential; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011602:Psychophysiologic Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D012640:Seizures / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D012720:Severity of Illness Index; D014743:Videotape Recording