{"id":8717,"date":"2025-12-09T06:48:10","date_gmt":"2025-12-09T05:48:10","guid":{"rendered":"https:\/\/neurohirurgija.in.rs\/?page_id=8717"},"modified":"2026-06-16T13:13:38","modified_gmt":"2026-06-16T11:13:38","slug":"seizures-after-brain-injury","status":"publish","type":"page","link":"https:\/\/neurohirurgija.in.rs\/en\/seizures-after-brain-injury\/","title":{"rendered":"Seizures After a Brain Injury (TBI, ICH, SAH, IVH) \u2014 Simple Explanation for Families"},"content":{"rendered":"\n
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\n Author:<\/span>\n \n Dr. Zeljko Kojadinovic, MD, PhD\n <\/a>\n \u2014 Neurosurgeon and Pain Management Specialist\n <\/div>\n\n
\n Specialized Experience:<\/span>\n 30 years of clinical expertise in neurosurgery and neurocritical care.\n <\/div>\n\n
\n Last medically reviewed:<\/span>\n June 03, 2026\n <\/div>\n<\/div>\n\n\n\n

Seizures can occur after many types of severe brain injury \u2014 including traumatic brain injury (TBI)<\/strong>, intracerebral hemorrhage (ICH)<\/strong>, subarachnoid hemorrhage (SAH)<\/strong>, intraventricular hemorrhage (IVH)<\/strong>, or a combination of these. A seizure happens when groups of brain cells start sending abnormal electrical signals. This can appear as shaking of the body, stiffening, staring spells, sudden unresponsiveness, or brief episodes where the patient seems \u201cnot there.\u201d<\/p>\n\n\n\n

In the ICU, seizures may be hard to recognize because patients are often sedated, connected to a ventilator, or unable to move. That is why doctors sometimes use continuous EEG monitoring<\/strong> to detect \u201csilent\u201d seizures that cannot be seen from the outside. If a seizure is confirmed or strongly suspected, doctors typically start antiepileptic medications<\/strong> to protect the brain from additional injury.<\/p>\n\n\n\n

Most early seizures after brain injury do not<\/em> mean the patient will develop chronic epilepsy. They are often a temporary reaction to swelling, bleeding, irritation of brain tissue, or metabolic changes. With proper monitoring and treatment, seizures can usually be controlled effectively, and they rarely change the long-term recovery path by themselves.<\/p>\n\n\n\n

Preventive Antiepileptic Treatment After TBI, ICH, SAH, or IVH<\/h2>\n\n\n\n

After severe injuries affecting the cerebral cortex<\/strong> (the outer layer of the brain), doctors often give antiepileptic medication for the first 7 days<\/strong>. This is called early seizure prophylaxis<\/em>. The medications most commonly used for 7-day seizure prevention are levetiracetam (Keppra) and, in some cases, phenytoin. Most modern ICU teams prefer levetiracetam because it is easier to dose, has fewer interactions, and does not require blood-level monitoring.<\/p>\n\n\n\n

The goal is simple: during the first days after a brain injury, the tissue is irritated, swollen, and unstable \u2014 and that is the period when early seizures are most likely to occur.<\/p>\n\n\n\n