Concussive convulsions after sports injury are not serious

On p 171 McCrory et al report on an investigation of the ictal phenomenology, aetiology, and outcome of convulsions occurring within seconds of impact in two violent collision sports–Australian rules football and elite rugby league. They analysed 22 cases, including four events documented on videotape. Videotaped convulsions began within 2 seconds of a facial blow and comprised a period of tonic stiffening followed by myoclonic jerks of all limbs lasting up to 150 seconds. Recovery of consciousness was rapid. No structural or permanent brain injury was present on clinical assessment, neuropsychological testing, or neuroimaging studies. All players returned to competition within two weeks. Epilepsy did not develop in any of the players, who were followed up for up to 13 years. The authors interpret these impact convulsions as a non-epileptic phenomenon, akin to convulsive syncope.


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