Posttraumatic Epilepsy Prophylaxis

Young, Byron; Rapp, Robert P.; Brooks, William H.; Madauss, William C.; Norton, Jane A.

doi:10.1111/j.1528-1157.1979.tb04851.x

Cited by 54 publications

(16 citation statements)

References 27 publications

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“…The AEDs used are phenobarbital (PB) + PHT [11], PHT [12][13], PB [14], and valproic acid (VPA) [15]. Each study included 62 to 390 patients with follow-up periods from 6 months to 13 years.…”

Section: Results Of Observational Studies For Prophylaxismentioning

confidence: 99%

Posttraumatic epilepsy and treatment

Chen

Ruff

Eavey

et al. 2009

JRRD

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Abstract-Posttraumatic epilepsy (PTE) is a major long-term complication of traumatic brain injury (TBI). PTE usually develops within 5 years of head injury. The risk for developing PTE varies with TBI type. Both Korean and Vietnam war veterans with penetrating TBI had a 53% risk of developing PTE. The risk of developing PTE is between 10% and 25% in combat-associated closed-head trauma with positive brain imaging and about 5% in moderately severe closed-head injury without imaging finding. We do not know the risk of PTE among Operation Iraqi Freedom/Operation Enduring Freedom veterans with minimal TBI because of blast exposure. Partial seizures may manifest with subtle behavioral alterations that can be mistaken for manifestations of posttraumatic stress disorder and improperly treated. Accidents and medical complications commonly occur during seizures. Sudden unexpected death in epilepsy is most frequent among 20-to 40-year-olds. Seizures increase the likelihood of refractory seizures years after TBI. Seizures are also a social stigma that compromise veterans' reintegration into society. People with uncontrolled epilepsy are not allowed to drive and have difficulty obtaining or maintaining employment. Optimal seizure control is essential to the physical and emotional health of veterans with TBI and to their ability to lead productive lives.

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Section: Results Of Observational Studies For Prophylaxismentioning

confidence: 99%

Posttraumatic epilepsy and treatment

Chen

Ruff

Eavey

et al. 2009

JRRD

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“…35% in non-phenytoin treated group after 1 years of trauma, which are less than the incidence which is shown in Young et al & Tempkin et al & other. (10) (11) This may be because of short duration of study & small study group.…”

Section: Observationmentioning

confidence: 99%

Effectiveness of Anti - Epileptic Drugs in Prophylaxis of Post Traumatic Epilepsy

Chaurasia¹,

Bhagel²,

Ahluwalia³

2015

jemds

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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.

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“…Concern regarding 1981) and is available as an intravenous prepits saturable hepatic metabolism (Richens & aration for the acute treatment of status epilep- Dunlop, 1975) and long term toxicity profile ticus with considerable safety (Wallis et al, including adverse cosmetic effects (Reynolds, 1968;Earnest et al, 1983). These factors 1975) may limit indications for chronic admin-together with its proven anticonvulsant efficacy, may make DPH a particularly attractive agent for short term seizure prophylaxis and, indeed, its use has been recommended following acute head injury (Young et al, 1979).…”

Section: Introductionmentioning

confidence: 99%

Protein binding and CSF penetration of phenytoin following acute oral dosing in man.

Brodie¹,

Muir²,

Agnew³

et al. 1985

Brit J Clinical Pharma

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1 Prophylactic phenytoin (DPH) has been evaluated in 20 patients undergoing diagnostic myelography. DPH (0.75 g) was ingested at 20.00 h the night before and 0.5 g at 08.00 h on the morning of the procedure. 2 Total DPH concentrations at myelography (mean + s.d.: 12.7 + 4.3 mg 1-1; range 6.3-21.5 mg 1-1) correlated with CSF values (1.3 ± 0.46 mg 1-1; range 0.7-2.2 mg 1-1; r = 0.83, P < 0.001). 3 DPH protein binding at that time varied two-fold (9.2-18.5%) and free drug levels (1.7 + 0.6 mg 1-1) correlated with CSF (r = 0.83, P < 0.001) and total (r = 0.89, P < 0.001) plasma DPH concentrations. 4 There were significant negative correlations between patient weight (n = 17) and total (r = -0.57, P < 0.05) and CSF (r = -0.55, P < 0.05) DPH concentrations at myelography. 5 Total plasma DPH levels 8 h (14.5 ± 3.9 mg 1-1; range 7.3-20.6 mg [-l) and 24 h (12.3 + 3.8 mg 1-1; range 5.0-19.8 mg 1-1) after myelography were largely within the 'therapeutic range' of 10-20 mg 1-1 for the drug. 6 No patient suffered a seizure although, in two, spike discharges were seen on a postmyelography electroencephalogram. 7 A simple regime involving two doses of DPH would provide acceptable plasma CSF concentrations as a basis for controlled studies in seizure prophylaxis following neuroradiological investigations involving intrathecal contrast.

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Posttraumatic Epilepsy Prophylaxis

Cited by 54 publications

References 27 publications

Posttraumatic epilepsy and treatment

Posttraumatic epilepsy and treatment

Effectiveness of Anti - Epileptic Drugs in Prophylaxis of Post Traumatic Epilepsy

Protein binding and CSF penetration of phenytoin following acute oral dosing in man.

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