What are the challenges to a brain injury case?
Brain injury cases can be some of the most difficult to run as a personal injury lawyer, not least because medical science is not clear on diagnoses and causation arguments can run into complex hurdles.
The classification of different types of brain injuries, especially in terms of severity and how this can interplay with conducting a brain injury case has been set out elsewhere.
It is well known that any brain injury in the moderate to severe category, under the Mayo classification and with Glasgow Coma scores of some positive indices, will often lead a neurologist or neurosurgeon to conclude that the risk of developing epilepsy for example is increased significantly.
What if the objective or other evidence does not confirm that on balance of probability there has been a brain injury of more than a mild nature and the claimant goes on to suffer seizures? Can seizures including epilepsy be caused by a mild TBI trauma?
What does the study say about injuries?
The answer is yes. One eminent study published in 2000 was the one produced by John Annegers and Sharon Pasternak Coan for The University of Texas at Houston USA. The purpose of the study was to determine whether a traumatic brain injury (TBI) increased the risk of later epilepsy. Included within the study was a data base which included a significant sample of those suffering mild TBI, including those without skull fracture and with loss of consciousness or post trauma amnesia of less than 30 minutes. By definition this would include those who may not even recall losing consciousness for example.
What was found was that there was a strong relationship between severity of the TBI and the risk of subsequent unprovoked seizures. In fact, for example unprovoked seizures occurring even more than 10 years after severe TBI can be attributed in large part to the injury. However, there was still a much higher risk of developing epilepsy. The risk of developing epilepsy is doubled compared to those who hadn’t suffered any brain injury for 5 years after the mild TBI and the evidence does not support that constitutional predisposition or other factors could be responsible for that overall increase.
One other point to bear in mind is that often non epileptic seizures result from brain injuries of all types. Quite often these non-epileptic seizures will be linked to psychological or psychiatric trauma also caused by the accident and may need further evidential input from either neuro psychiatrist or neuro psychologist.
The affects of a brain injury
We know of course also that even a mild brain injury can lead to significant cognitive deficits. These deficits can affect people in certain types of employment and have devastating consequences. For example, for some who is in a demanding high powered job where she or he is required to give regular verbal briefings and presentations. Where what is considered a very slight verbalisation impairment may lead to loss of confidence to the extent that the viability of the job may be in question and this can lead to very significant financial implications.
A diagnosis of epilepsy can be equally devastating even if not accompanied by any of the above conditions. For example, a loss of a driver’s licence and also impact in a significant loss of confidence and self-esteem. Not to mention the fact that this dramatically impacts the person’s ability to travel.
So, to conclude, don’t assume you need to have had a severe brain injury to link it to onset of seizures of any type.