Single punch → immediate collapse → stiffening ± seizure
🧠 Likely causes (with rough real-world percentages)
1. Concussive (impact) seizure
👉 ~70–80%
Why so common:
👉 This is the default assumption if timing is immediate
2. Simple concussion (no true seizure, just posturing)
👉 ~10–20%
👉 Important distinction:
3. Intracranial bleed / contusion
(Subdural haematoma,
Epidural haematoma,
Intracerebral haemorrhage)
👉 ~5–10% initially (but highest risk)
👉 Lower probability, but:
⚠️ highest danger
4. Hypoxic seizure (e.g. choke, airway compromise)
👉 <5%
- 70–80% → concussive seizure (benign, immediate)
- 10–20% → non-epileptic posturing (also benign)
- 5–10% → intracranial bleed/contusion (dangerous)
- <5% → hypoxia/other
- 70–80% → concussive seizure (benign, immediate)
- 10–20% → non-epileptic posturing (also benign)
- 5–10% → intracranial bleed/contusion (dangerous)
- <5% → hypoxia/other
🧠 Likely causes (with rough real-world percentages)
1. Concussive (impact) seizure
👉 ~70–80%
- Happens immediately or within seconds
- Brief tonic stiffening ± jerks
- Rapid recovery (minutes)
Why so common:
- Mechanical force → sudden neuronal depolarisation
- No structural damage required
- Seen in boxing, rugby, MMA
👉 This is the default assumption if timing is immediate
2. Simple concussion (no true seizure, just posturing)
👉 ~10–20%
- Looks like seizure (stiffening, fencing posture)
- But actually:
- transient brainstem release
- not true epileptic discharge
👉 Important distinction:
- no ongoing seizure activity
- very brief
3. Intracranial bleed / contusion
(Subdural haematoma,
Epidural haematoma,
Intracerebral haemorrhage)
👉 ~5–10% initially (but highest risk)
- May also present immediately with seizure
- OR may deteriorate later
👉 Lower probability, but:
⚠️ highest danger
4. Hypoxic seizure (e.g. choke, airway compromise)
👉 <5%
- More relevant if:
- strangulation involved
- prolonged collapse
