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

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.