Epilepsien durch intrazerebrale Schussverletzungen

Zusammenfassung

Schussverletzungen sind als ziviles Trauma eine seltene Ursache einer symptomatischen Epilepsie. Wir berichten über drei Patienten, die infolge einer Schussverletzung eine Epilepsie entwickelten. Die Schüsse erfolgten im Ehestreit, durch eine versuchte Tötung und als Unfall. Zwei Patienten erlitten Spätanfälle (ab Tag 8 nach der Verletzung), ein Patient Frühanfälle. Bei zwei Patienten verblieben Metallteile intrazerebral. Bei allen drei Patienten gestaltete sich die antikonvulsive Therapie effizient. Im Gegensatz zu militärischen Kopfverletzungen, die sich oft auch als penetrierende Schussverletzungen darstellen, ist die zivile Kopfverletzung offenbar mit einer deutlich günstigeren Behandlungsprognose verbunden.

Abstract

Trauma due to penetrating gun-shot injury of the head in the civilian population is a rare cause for post-traumatic epilepsy. The following report concerns three patients who developed epileptic seizures due to a civilian penetrating gun-shot injury. The shots were fired in the context of a domestic quarrel, an attempted homicide and a domestic misfortune. Two patients suffered late post-traumatic seizures (more than eight days after trauma), one patient developed early post-traumatic seizures (within seven days). In two of the three patients metal fragments were retained intracerebrally. All three patients became seizure-free with prolonged antiepileptic drug treatment. In contrast to military series, traumatic brain injury caused by penetrating gun-shot injury seems to have a much better prognosis in the civilian population.

Schlüsselwörter

Schussverletzung - posttraumatische Epilepsie - Antiepileptika

Key words

penetrating gun-shot injury - post-traumatic epilepsy - antiepileptic drugs

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