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Golf ball epilepsy
  1. DAVID CHADWICK,
  2. DANIELA B CLEAR,
  3. PAUL ELDRIDGE,
  4. CONNOR MALUCCI
  1. The Walton Centre for Neurology and Neurosurgery, Lower Lane, Liverpool L9 7LJ, UK
  1. Professor D Chadwick, University Department of Neurological Science, The Walton Centre for Neurology and Neurosurgery, Lower Lane, Liverpool L9 7LJ, UK

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(A) CT showing acute extradural haematoma in patient 1. (B) CT 5 days after A showing persisting cortical abnormality after evacuation of extradural haematoma. (C) CT demonstrating minor depressed skull fracture at site of impact. (D) CT showing late cortical changes at presumed site of impact 4 years after injury.

Blunt head injuries may cause epilepsy. We present the cases of four young people whose heads were all subject to contact with golf balls travelling at speed. Each had post-traumatic seizures, three early and one late, despite the apparent absence of post-traumatic amnesia. Although many patients who develop epilepsy recall some type of head injury preceding their first seizure, post-traumatic epilepsy probably accounts for less than 5% of all the epilepsies.1 There is good evidence that the risk of post-traumatic epilepsy increases with the severity of the injury. Thus, Jennett2 identified the presence of intracranial haemorrhage, dural laceration, and early post-traumatic seizures as the chief risk factors for late post-traumatic epilepsy. Annegerset al also emphasised that in the absence of a post-traumatic amnesia of 30 minutes or greater, there was no significant increased risk for the development of post-traumatic epilepsy.3

From a practical point of view and for medicolegal purposes, it is necessary to decide if a seizure is post-traumatic. As a …

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