{"id":"3502f9d7-ab5b-47fe-b449-0be7e093d502","slug":"multicenter-and-prospective-trial-of-anti-epileptics-for-early-seizure-prevention-in-mild-traumatic-brain-injury-with-a-positive-computed-tomography-scan","title":"Multicenter and prospective trial of anti-epileptics for early seizure prevention in mild traumatic brain injury with a positive computed tomography scan","authors":["Matthew Pease","Mazen Zaher","Alejandro J. Lopez","Siyuan Yu","Tanya Egodage","Suzan Semroc","Dooman Arefan","Brian Jankowitz"],"abstract":"Background: Posttraumatic seizures (PTSs) are a major source of disability after traumatic brain injury (TBI). The Brain Trauma Foundation Guidelines recommend prophylactic anti-epileptics (AEDs) for early PTS in severe TBI, but high-quality evidence is lacking in mild TBI. Methods: To determine the benefit of administering prophylactic AEDs, we performed a prospective and multicenter study evaluating consecutive patients who presented to a Level 1 trauma center from January 2017 to December 2020. We included all patients with mild TBI defined as Glasgow Coma Scale (GCS) 13–15 and a positive head computed tomography (CT). Patients were excluded for previous seizure history, current AED use, or a neurosurgical procedure. Patients were given a prophylactic 7-day course of AEDs on a week-on versus week-off basis and followed with in-person clinic visits, in-hospital evaluation, or a validated phone questionnaire. Results: Four hundred and ninety patients were enrolled, 349 (71.2%) had follow-up, and 139 (39.8%) were given prophylactic AEDs. There was no difference between seizure rates for the prophylactic AED group (0.7%) and those without (2.9%; P = 0.25). Patients who had a PTS were on average older (81.4 years) than patients without a seizure (64.8 years; P = 0.02). Seizure rate increased linearly by age groups: 80 years old (4.6%). Conclusion: Prophylactic AEDs did not provide a benefit for PTS reduction in mild TBI patients with a positive CT head scan.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/3502f9d7-ab5b-47fe-b449-0be7e093d502/featured/hero-1781561271149.png","publishDate":"2022-06-10T00:00:00.000Z","doi":"10.25259/SNI_38_2022","categories":["Trauma","Original Article"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2022/06/11650/SNI-13-241.pdf"}