# New‐Onset Complex Partial Seizures Progressing to Intractable Epilepsy in a Young Female With Bifrontal Encephalomalacia and a Remote History of Traumatic Brain Injury

## TL;DR

A young woman developed severe epilepsy six years after a brain injury, highlighting the long-term risks of traumatic brain injury.

## Contribution

This case emphasizes the underrecognized risk of delayed epilepsy from encephalomalacia following traumatic brain injury.

## Key findings

- A young female developed intractable epilepsy six years after traumatic brain injury.
- Bifrontal encephalomalacia was identified as a contributing factor to delayed-onset seizures.
- Strict medication adherence and long-term follow-up are critical for managing post-TBI epilepsy.

## Abstract

Encephalomalacia, the irreversible loss of brain tissue following injury, is a well‐documented cause of post‐traumatic epilepsy, typically manifesting within the first year. However, delayed‐onset intractable epilepsy in young adults remains underrecognized. We present a case of a young female with bifrontal encephalomalacia secondary to a traumatic brain injury (TBI) six years prior who developed complex partial seizures progressing to intractable epilepsy. Electroencephalography (EEG) confirmed seizure activity predominantly from the right frontal lobe. Despite multiple anti‐seizure medications, the patient required intensive care management for refractory status epilepticus. This case highlights the potential for chronic epileptogenesis in TBI survivors, emphasizing the need for long‐term vigilance, strict medication adherence, and proactive follow‐up to optimize seizure control and prevent recurrence.

Post‐traumatic encephalomalacia is an underrecognized cause of delayed‐onset epilepsy in young adults. This case highlights a young female who developed intractable epilepsy six years after a minor TBI, attributed to bifrontal encephalomalacia. The progression underscores the need for early diagnosis, strict medication adherence, and long‐term follow‐up in TBI patients.