Rehabilitation of Post-Traumatic Epilepsy Through Neurofeedback and Motor Therapy: A 6-Month Follow-Up Case Study

Background: /Objectives: Post-traumatic epilepsy (PTE) is a frequent complication of Traumatic Brain Injury (TBI), often contributing to exacerbate functional and neurological impairment. Since PTE is difficult to treat with traditional anticonvulsive therapies, there is a strong need for alternative strategies that optimize rehabilitation outcomes. This case study highlights the possible beneficial effects of the combined use of neurofeedback (NFB) and motor therapy in improving motor and cognitive functioning. Methods: The patient, hospitalised for TBI and who developed PTE, underwent baseline quantitative EEG (qEEG), neuromotor, functional and neuropsychological assessment before starting a three-week rehabilitation program (five days a week) integrating 30 sensorimotor (SMR) NFB training sessions, each lasting 35 minutes, with daily one-hour motor therapy. qEEG and clinical assessments were repeated post-intervention and after 6 months to evaluate treatment outcomes and their durability. Results: qEEG revealed significant post-intervention reductions in Delta and Theta power, indicating reduced cortical slowing and enhanced neural activation. Relative power analysis showed decreased Theta activity and normalization in Alpha, suggesting overall cortical activity stabilization. Significant improvement was observed in Beta and High-beta activity. The Theta/Beta ratio showed significant reductions, consistent with enhanced attentional regulation. Cognitive outcomes demonstrated reliable improvements in global cognition, memory, and visuospatial abilities, with most gains maintained or improved at follow-up, accompanied by marked reductions in depressive and anxiety symptoms. Motor and functional assessments indicated relevant gains in motor performance, coordination, and independence. Conclusions: Findings indicate that integrating NFB with motor therapy can foster sustained neuroplasticity and enhance recovery in PTE, considering the lack of available successful treatment options.