Thread by @hyderabaddoctor

Do anti-seizure medications (ASM) prevent late post-traumatic epilepsy?

1. Traumatic brain injury (TBI) is unfortunately a common cause of disability and death. Seizures after head injury can adversely affect the outcome of patients with TBI. Does early ASM help?
#MedTwitter

2. A recent systematic analysis looked at the possible role of ASM in preventing early & late post-traumatic seizures, and in reducing the risk of death.
cp.neurology.org/content/13/3/e…

#TBI #epilepsy #neurotwitter

3. The risk of early post-traumatic seizures (occurring within the first 7 days after injury) was significantly reduced in the group taking anti-seizure medications.

4. The risk of late post-traumatic seizures (epilepsy) at 18 and 24 months did not reduce in the group taking ASM as compared to those who did not take ASM. The death rate was also similar in groups taking or not taking ASM.

5. Conclusions
*Anti-seizure medications reduce the risk of early seizure recurrence in patients with traumatic brain injury.
*Prophylactic use of anti-seizure drugs does not reduce the risk of long-term epilepsy or death in patients with moderate-severe traumatic brain injury.

6. Take home message
*We need to weigh the benefits (lower risk of early post-traumatic seizures) and risks (adverse effects of anti-seizure drugs) before starting anti-seizure prophylaxis.
*More studies are needed to decide the benefits & risks of long term ASM use after TBI.