Post Concussion Syndrome: Brainstem Seizures, a Case Report

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Abstract
Following head injury and associated unconsciousness, a 19 year old woman developed chronic intractable headaches, absence attacks and a cluster of other symptoms which did not respond to conventional medical therapy. During the course of implanting a brain stimulation electrode for the treatment of chronic and recurring incapacitating headaches, diagnostic electrographic recordings revealed focal abnormal discharges in the mesothalamus. Electrical stimulation attenuated the discharges and alleviated the headaches and associated symptoms. A retrospective analysis of this case suggested that a head injury-induced brain stem gliosis was the source of the brainstem abnormal discharges. It is speculated that various biologic systems represented within the brainstem were implicated by the reticular formation generated discharges. Symptoms making up the chronic pain syndrome were thus thought to emanate from the electric malfunctioning of those biologic systems.