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Traumatic brain injury has been recognized as a cause of epilepsy since antiquity.1 Over the millennia, the mechanisms of brain injury have evolved from blunt head trauma to high-velocity penetration and ballistic pressure waves during military conflict to motor vehicle accidents within the civilian population. Latency between injury and development of epilepsy was reported by Duretus (1527–1586) with his description of a 17-year-old boy with seizures beginning 5 years after he had “a bone of the skull broken and depressed . . .” Charcot divided the etiology of epilepsy into direct and indirect wherein there was immediate, periconcussive seizures or seizures occurring later after trauma with the association made by the clinical history.1
Numerous detailed studies of wounded soldiers have provided valuable information about this specific population of people with penetrating head injuries.2,3 The risk of a military veteran developing posttraumatic epilepsy (PTE; i.e., the development of recurrent, spontaneous seizures more than 1 week after head injury) in this setting is extremely high, and the observations from different wars have been remarkably …
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