Effect of Newer Generation Anticonvulsant Prophylaxis on Seizure Incidence After Spontaneous Intracerebral Hemorrhage

Preventing seizure occurrence following spontaneous intracerebral haemorrhage: A systematic review and meta-analysis of seizure prophylaxis

“…This suggested that phenytoin prophylaxis may not be effective. This information was supported by Christie et al's study [6], which reported almost exclusive use of levetiracetam for seizure prophylaxis and a decrease in seizure occurrence. Further studies are needed to compare the efficacy of phenytoin and levetiracetam in patients with a high risk of seizure occurrence.…”

“…We analysed more studies for seizure occurrence than 3 previous meta-analyses [21][22][23] and included in our meta-analysis more patients than were included in 2 of those [21,22] and Christie et al's study [6], which was published very shortly before our second search. Although most of the studies in our meta-analysis were high quality, we identified only one randomized controlled trial that had also been included in the 3 previous meta-analyses.…”

“…From 245 records, we identified 8 studies with a total of 2852 patients for our meta-analysis (Appendix B and Table 1). There was one randomized controlled trial [16] and 7 observational cohort studies [5][6][7][8]11,[17][18][19][20].…”

“…Current data regarding the efficacy of seizure prophylaxis have been controversial. Some studies suggest that seizure prophylaxis after spontaneous ICH is associated with the prevention of seizure occurrence [5,6], although others report that seizure prophylaxis has no effect [7,8]. Furthermore, the latter studies demonstrated an association between seizure prophylaxis in general and poor functional independence 90 days after ICH [7,8].…”

Comparative Effectiveness and Safety of Seizure Prophylaxis Among Adults After Acute Ischemic Stroke

“…14,46 Seizures and seizure-like events are considered AIS symptoms (ie, symptomatic seizures), and prophylaxis may be unnecessary unless they recur after the acute AIS recovery period is over (ie, post-AIS epilepsy, by definition). 11,47,48 The most examined ASDs have been levetiracetam, 37,39,40 valproic acid, 38 and sodium valproate, 41 with an urgent need to evaluate the safety and effectiveness of newer drugs such as lacosamide, carbamate, brivaracetam, vigabatrin, and eslicarbazepine. 49 Evidence shows the side effects of levetiracetam are as follows: behavioral disturbances (eg, anxiety, anger, and depression), nausea/vomiting, infections, somnolence, and fatigue that may precipitate fall-related injuries.…”