Head injury patients benefit from seizure meds
Head injury patients benefit from seizure meds
Anticonvulsants help minimize late seizures
Patients who suffer severe head injury commonly have post-traumatic seizures that occur any time from shortly after the injury to months or even years later. When seizures develop more than seven days after injury, the probability of additional seizures is high. Those patients should be treated aggressively with anticonvulsant medication, say researchers at the University of Washington in Seattle.
Researchers conducted a longitudinal study of 63 moderately to severely head-injured adults who developed late post-traumatic seizures. Study participants suffered the seizures while participating in a randomized, placebo-controlled study of the effectiveness of phenytoin to prevent post-traumatic seizures.
Depressed skull fractures increase risk
Researchers measured the time from the first unprovoked late seizure to time of seizure recurrence and found that 86% of patients experienced more late seizures within two years. Other findings include the following:
· Of patients studied, there was a 47% chance of having another unprovoked seizure within one month of the first late seizure.
· The incidence of seizure recurrence was 69% by six months, increasing to 82% by 12 months, and 86% by 24 months.
· The frequency of recurrent seizures varied widely. More than 50% of patients experienced at least five late seizures. Another 37% of patients had 10 or more late seizures within the two-year period.
In addition, researchers note that the risk of having another seizure after the initial late seizure was greater for persons whose head injuries were characterized by a depressed skull fracture or an acute subdural hematoma. The risk of having five or more late seizures was greatest for patients having prolonged coma of more than seven days.
Most patients in the study suffered from closed head injuries and were treated with anticonvulsant medication after their first late seizure. Without medication, the seizures might have recurred earlier and been more frequent and severe, say researchers.
[See: Haltiner AM, Temkin NR, Dikmen SS. Risk of seizure recurrence after the first late post- traumatic seizure. Arch Phys Med and Rehab 1997; 78:835-840.]
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