Effectiveness of anti-epileptic drugs in prophylaxis of post traumatic epilepsy. AIM: To determine the incidence of epileptic seizure after traumatic brain injury in case with or without antiepileptic prophylaxis and to determine the role of AEDs after 7 days of trauma. METHODS: This study represents a randomized case control study. The sample of patient. Considered was of adult patients >13yrs age of both sexes with severe brain injury admitted in Hamidia Hospital Bhopal. On admission a detailed history of any previous episode of seizure before trauma was taken. If prior seizures were present then patient was excluded from study. Every patient of head injury having brain injury or skull fracture was given a loading dose of anticonvulsants (phenytoin) of dose 20mg/kg body weight then continued anticonvulsants for coming 7 days in maintenance dose of 5mg/kg/day and then stopped. Patient & attendants are explained about the seizure. RESULT: Out of total 300 study eligible patients, 15 have late post traumatic seizure, all with GCS at the time of admission was <8. In this 15 cases, 9 were in group who were given antiepileptic drug prophylaxis & in rest of 6 patients antiepileptic drug prophylaxis was given for period of 7 days only after traumatic brain injury and then stopped. Maximum cases are seen in age group 20-29 yr and mostly are males. Of all 15 patients, 7 were operated & 8 were kept on conservative treatment, the non-operative patients as well as operated case had post traumatic seizure. CONCLUSION: On basis of our study analysis we conclude that continued phenytoin treatments cannot reduce the late post traumatic seizure but is effective in first week of significant traumatic brain injury.
Background: Traumatic brain injury is one of most common cause of death in road traffic accident. Most of these classified as mild injury, with approximately 20% classified as moderate to severe. Approximate 50% of the 150,000 trauma deaths every year are caused by head injury.Methods: A prospective cross-sectional study was conducted on 150 patients with a head injury admitted in the Hamidia hospital, Bhopal. The assessment of the severity of head injury using Glasgow coma scale (GCS) at the time of admission, follow up on 5 days and 15 days respectively. The collected data were transformed into variables, coded and entered in Microsoft excel. Data were analyzed and statistically evaluated using statistical package for the social sciences (SPSS)-PC-21 version.Results: Out of 150, a total of 115 patients had no midline shift while 35 patients were having midline shift. Severe head injury patients (GCS 3-8) were having more morbidity and mortality. Moderate head injury (GCS 9-13) was associated with good prognosis and low mortality. A greater degree of midline shift of (more than 5 mm) is indicated severe head injury and is significantly associated with morbid outcome and higher mortality.Conclusions: In our study, road traffic accidents is the most common cause of head injury, with males being affected more than females. The degree of midline shift on computed tomography (CT) scan head in patients with head injuries was found to be significantly associated with high mortality and morbidity.
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