Chronic Traumatic Encephalopathy (CTE) is a progressive neurodegenerative disease linked to repetitive head impacts. While seizures are not a universal symptom of CTE, this article explores the potential connection between CTE and seizure activity.
What is Chronic Traumatic Encephalopathy?
Chronic Traumatic Encephalopathy (CTE) is a degenerative brain disease that worsens over time. It is specifically linked to repeated trauma to the head, including concussions and subconcussive impacts.
A defining feature of CTE is the abnormal accumulation of tau protein. This tau protein forms tangles around blood vessels in specific brain regions, a hallmark change. This protein buildup is thought to contribute to the cognitive, behavioral, and physical impairments seen in individuals with the condition.
CTE was first recognized in boxers. However, CTE is now understood to affect various individuals exposed to repetitive head trauma, including those in contact sports like football and rugby, and military veterans. The exact amount of trauma required for CTE to develop remains unknown.
Currently, a definitive diagnosis of CTE can only be made after death, through a post-mortem examination of brain tissue. While research is ongoing to develop methods for diagnosis during life, no validated tests are available at this time.
What are Seizures?
Seizures are sudden, uncontrolled electrical disturbances that occur in the brain. These disruptions can lead to changes in a person’s behavior, movements, feelings, or level of consciousness. Normally, brain cells communicate through orderly electrical signals, but during a seizure, this activity becomes abnormal.
Seizures can manifest in various ways, depending on their origin and spread in the brain. Some seizures might involve the entire brain, leading to generalized symptoms like full-body convulsions. Other seizures, known as focal seizures, may begin in a specific area and cause more localized effects, such as unusual sensations or involuntary movements.
The manifestation of a seizure can range from subtle changes in awareness to physical movements. For instance, a person might stare blankly, make repetitive movements, or experience a brief loss of consciousness. The duration of seizures also varies, typically lasting from a few seconds to a few minutes.
Connecting CTE and Seizure Activity
While seizures are not considered a universal or primary symptom of CTE, they have been reported in some individuals diagnosed with the condition. Research indicates that a history of traumatic brain injury (TBI) can increase the risk of developing seizures. This risk generally increases with the severity of the head injury.
The precise mechanisms linking CTE to seizure susceptibility are still under investigation, but several neuropathological factors contribute. The abnormal accumulation of tau protein, a hallmark of CTE, can disrupt normal neuronal function and communication within the brain. This proteinopathy may contribute to neuronal hyperexcitability.
The chronic neuroinflammation and neuronal loss observed in CTE brains could also alter brain circuitry. Inflammation can persist and lead to improper rewiring of the brain, potentially increasing seizure risk. Changes in brain structure and diffuse axonal injury, common in CTE, might also create an environment conducive to abnormal electrical activity.
Studies exploring this connection have yielded complex results, underscoring the ongoing nature of this research. For example, some pilot studies have identified tau pathology suggestive of CTE in a small percentage of younger epilepsy patients with a history of head injuries, though this was not a widespread finding. While a link exists, it may not be present in all cases of head trauma or epilepsy, and further research is needed to fully understand the prevalence and causal relationship.
Diagnosis and Management Considerations
Diagnosing Chronic Traumatic Encephalopathy presents significant challenges, as it can only be definitively identified through a post-mortem brain examination. This limitation means clinicians cannot directly confirm CTE during life, complicating the understanding and management of its symptoms, including seizures. Therefore, if seizures occur in an individual with a history of repetitive head trauma consistent with CTE, their management typically focuses on symptomatic treatment.
When seizures arise in this context, they are generally managed using anti-epileptic medications. The goal of medication is to control abnormal brain activity and reduce seizure frequency and severity. Effective medication and dosage require careful neurological evaluation and monitoring.
A thorough neurological evaluation is important for anyone experiencing seizure-like activity, especially with a history of head trauma. While the underlying CTE cannot be treated directly during life, effective management of seizures can significantly improve a person’s quality of life and safety.