It is often difficult to evaluate the postictal patient presenting after a concurrent seizure and traumatic event. Which came first, the chicken or the egg? Did the seizure cause the trauma, or did the trauma cause the seizure? Does the patient have a preexisting seizure disorder, or is this a true posttraumatic seizure due to new brain injury? Neidlinger and colleagues retrospectively examined this important, common clinical scenario in a review of 356 trauma patients presenting with the additional diagnosis of seizure. Their data reinforce previous findings of lower GCS scores and higher likelihood of CT-proven brain injury in patients in whom the seizure resulted from an injury vs those in which the seizure preceded the trauma.
Haut ER. Head Computed Tomography Scans in Trauma Patients With Seizure Disorder—Invited Critique. Arch Surg. 2005;140(9):864. doi:10.1001/archsurg.140.9.864