Early Seizure Prophylaxis in Mild and Moderate Traumatic Brain Injury
Published on: April 29, 2024
Following mild or moderate traumatic brain injury (TBI) seizure prophylaxis was linked to a small, but significant, lower risk of early posttraumatic seizures (PTS), according to new research. The systematic review and meta-analysis included eight studies (with 5,627 patients) for the mild and moderate TBI analysis and five studies (with 3,803 patients) for the mild TBI analysis. Mild TBI was defined as 13-15 on the Glasgow Coma Scale (GCS), while moderate TBI was defined as a GCS of 9-12. Overall, the rate of early PTS ranged from 0%-4%. Prophylaxis for early PTS in mild to moderate TBI and mild TBI alone resulted in an absolute risk reduction of 0.6%. When considering early seizure prophylaxis in this patient population, the researchers suggest weighing the low prevalence of early seizures and the small absolute risk reduction with the possible risks of antiseizure drugs and inappropriate continuation for longer than 1 week.