Pharmacological treatments for preventing epilepsy following traumatic head injury

Thompson, Kara; Pohlmann-Eden, B.; Campbell, Leslie Anne; Abel, Hannah

doi:10.1002/14651858.cd009900.pub2

Cited by 81 publications

(87 citation statements)

References 71 publications

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“…Additionally, recent evidence suggests that prophylactic anticonvulsants like phenytoin in stroke/TBI are associated with worse functional outcomes, possibly due to reduced axonal/growth cone bursting from sodium channel suppression which may inhibit rewiring (Bhullar et al, 2014). The optimal timing of seizure prophylaxis after brain injury, if beneficial at all, remains open to debate (Thompson et al, 2015). …”

Section: The Biology Of Neurological Injurymentioning

confidence: 99%

Enhancing Nervous System Recovery through Neurobiologics, Neural Interface Training, and Neurorehabilitation

et al. 2016

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After an initial period of recovery, human neurological injury has long been thought to be static. In order to improve quality of life for those suffering from stroke, spinal cord injury, or traumatic brain injury, researchers have been working to restore the nervous system and reduce neurological deficits through a number of mechanisms. For example, neurobiologists have been identifying and manipulating components of the intra- and extracellular milieu to alter the regenerative potential of neurons, neuro-engineers have been producing brain-machine and neural interfaces that circumvent lesions to restore functionality, and neurorehabilitation experts have been developing new ways to revitalize the nervous system even in chronic disease. While each of these areas holds promise, their individual paths to clinical relevance remain difficult. Nonetheless, these methods are now able to synergistically enhance recovery of native motor function to levels which were previously believed to be impossible. Furthermore, such recovery can even persist after training, and for the first time there is evidence of functional axonal regrowth and rewiring in the central nervous system of animal models. To attain this type of regeneration, rehabilitation paradigms that pair cortically-based intent with activation of affected circuits and positive neurofeedback appear to be required—a phenomenon which raises new and far reaching questions about the underlying relationship between conscious action and neural repair. For this reason, we argue that multi-modal therapy will be necessary to facilitate a truly robust recovery, and that the success of investigational microscopic techniques may depend on their integration into macroscopic frameworks that include task-based neurorehabilitation. We further identify critical components of future neural repair strategies and explore the most updated knowledge, progress, and challenges in the fields of cellular neuronal repair, neural interfacing, and neurorehabilitation, all with the goal of better understanding neurological injury and how to improve recovery.

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Section: The Biology Of Neurological Injurymentioning

confidence: 99%

Enhancing Nervous System Recovery through Neurobiologics, Neural Interface Training, and Neurorehabilitation

et al. 2016

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“…There exists low quality evidence supporting the use of phenytoin to prevention of early post trauma seizures and no evidence to show that phenytoin use prevents late onset seizures or that it prevents mortality 16 the results here seem to indicate that convulsions should be prevented. Otorrhoea, loss of consciousness, rhinorrhoea, Intra cerebral haematoma and admission to the ICU were all associated with poor outcomes.…”

Section: Discussionmentioning

confidence: 58%

Patient Profile and Outcomes of Traumatic Extradural Haematomas as Seen at The Nakuru Level Five Hospital in Kenya

Nasio¹

2017

East. Cent. Afr. J. Surg.

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Background: An extradural haematoma (EDH) also referred to as epidural haematoma is a collection of blood between the skull and the dura. Extradural haematomas are present in 1-2% of all head injury patients. In those who present in coma, extradural haematomas are present in 10% of them. Mortality rates have been reported to range from 5-43% in different regions of the world. Mortality is reportedly nil in patients who present without coma and 20% for those who present comatosed. Methods: A prospective cross sectional descriptive study of patients diagnosed with extradural haematoma by CT scan conducted at the Nakuru level five hospital between 1 st January 2015 and 30 th November 2015. Descriptive patient demographic data, clinical presentation data, investigations, surgical treatments offered, length of hospital stay and outcomes were captured using a questionnaire. Results: A total of 32 patients with extradural haematoma were recruited into the study. There was a male preponderance that accounted for 96.8% of patients. Their ages ranged from 5 to 64 years with a mean age of 30.75 years (+ 13.6) and. The commonest cause of injury was assault at 31.3% of all head injury patients followed by motorcycle related accidents at 28.1%. There were 34.4% mildly injured patients, 43.8% moderate and 21.9% of patients severely head injured. There were 8 deaths (25%) of the patients and 59.4% of the patients had good recovery. Low GCS, rhinorhoea, otorhoea, presence of an intracerebral haematoma, admission to the ICU, convulsions and loss of consciousness were associated with poor outcome.( p=0.00, 0.001, 0.022, 0.002, 0.009, 0.000, and 0.044 respectively). Conclusion: The extradural haematoma patient is mostly a young male. The commonest cause of extradural haematoma is assault/violence related followed by motorcycle accidents. There is an important co relationship between Glasgow coma score and outcome. Likewise Convulsions, loss of consciousness at any time after injury, otorhoea , rhinorhoea and presence of associated injuries worsened outcomes in this subset of extradural haematoma patients.

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“…Traumatic brain injury (TBI), which is also known as head injury (1)(2)(3), is a leading cause of mortality and morbidity (1,(4)(5)(6), especially among those of young ages (1).…”

Section: Contextmentioning

confidence: 99%

Erythropoietin for Traumatic Brain Injury: A Systematic Review and Meta-Analysis

Meshkini¹,

Meshkini²,

Sadeghi‐Bazargani³

2016

Trauma Mon

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Context: Traumatic brain injury (TBI) is a leading cause of mortality and morbidity; despite the use of neuroprotective agents for TBI management, no evidence-based recommendation for any particular neuroprotective agent with favorable outcomes and less adverse effects has been made in TBI management. Objectives: We aimed to assess the efficacy of erythropoietin (EPO) use for TBI management. Data Sources: This study is part of a review on neuroprotective agents used for traumatic brain injury: A systematic review and meta-analyses was done, based on a wide search strategy incorporating information from Cochrane CENTRAL, MedLine/PubMed, SCOPUS, Thomson Reuters Web of Science, SID.ir, Barekat Foundation, and clinicaltrials.gov databases up to September 06, 2015. Study Selection: The present study limited the retrieved search results only to those using EPO for TBI management. Data Extraction: The retrieved randomized clinical trials (RCTs) were assessed for their quality of reporting according to the consolidated standards of reporting trials (CONSORT) checklist prior to extracting the data for meta-analysis. The meta-analyses in this review was conducted using the extended Glasgow outcome scale (GOS-E) for acute TBI patients, mortalities, and adverse-effects. Results: Four RCTs were retrieved on EPO use for acute TBI, and two of them were kept for the final analysis. The analysis of the enrolled 645 participants in these studies showed insignificant but slightly better outcomes in the placebo group, while a significant reduction in mortality rates among EPO users was observed. Slightly better outcomes in vascular and non-vascular side-effects were also observed in the intervention group. Conclusions: EPO may be considered as effective in reducing TBI mortality and vascular side-effects, while there is no evidence to support any benefits in other outcomes or for the elimination of non-vascular side-effects. Further studies, especially well-designed phase-III dose-controlled trials, are needed for building a stronger body of evidence for recommending the use of EPO for acute TBI.Keywords: Head Injury, Traumatic Brain Injury, Neuroprotective Agent, Erythropoietin, Review ContextTraumatic brain injury (TBI), which is also known as head injury (1-3), is a leading cause of mortality and morbidity (1, 4-6), especially among those of young ages (1).Epidemiological studies have demonstrated the following facts about TBI in the U.S. (1, 4): -There is an incidence rate of 558 cases per 100,000 people each year.-TBI-related disability cases are estimated as rising by 33 new cases per 100,000 people each year.-They cause more than 50,000 deaths each year.-Motor vehicle collisions (MVC) are responsible for 50% of TBI cases.TBI costs more than $48 billion a year, and between 2.5 and 6.5 million Americans alive today have been victims of a TBI-related assault. Survivors of TBI are often left with significant cognitive, behavioral, and communicative disabilities (7).Erythropoietin (EPO) is a glycoprotein hormone of the cy...

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Pharmacological treatments for preventing epilepsy following traumatic head injury

Cited by 81 publications

References 71 publications

Enhancing Nervous System Recovery through Neurobiologics, Neural Interface Training, and Neurorehabilitation

Enhancing Nervous System Recovery through Neurobiologics, Neural Interface Training, and Neurorehabilitation

Patient Profile and Outcomes of Traumatic Extradural Haematomas as Seen at The Nakuru Level Five Hospital in Kenya

Erythropoietin for Traumatic Brain Injury: A Systematic Review and Meta-Analysis

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