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Unveiling the Role of Seizure Prophylaxis in Mild and Moderate Traumatic Brain Injury

This is a synopsis of original peer-reviewed clinical research published in JAMA Neurology, 8 April 2024

The use of seizure prophylaxis after mild to moderate traumatic brain injury (TBI) remains a topic of debate, despite established guidelines advocating its use in severe cases. This study aimed to clarify the relationship between seizure prophylaxis and the reduction of early posttraumatic seizures (PTS) in mild and moderate TBI. 

Conducted across multiple trauma centres in high-income countries, this observational analysis involved 8 studies comprising 5637 patients with mild to moderate TBI and 5 studies including 3803 patients with mild TBI.

The researchers report that the absolute risk reduction associated with seizure prophylaxis for early posttraumatic seizures (PTS) in mild to moderate traumatic brain injury (TBI) cases with a Glasgow Coma Scale (GCS) of 9-15 was 0.6% (95% CI, 0.1%-1.2%; P = .02). Similarly, for mild TBI alone, the absolute risk reduction was 0.6% (95% CI, 0.01%-1.2%; P = .04). 

While the results suggest that providing seizure prophylaxis was associated with a slight reduction in the risk of early posttraumatic seizures among individuals with mild to moderate traumatic brain injury, the researchers emphasize the importance of weighing these benefits against the potential risks of prescribing antiseizure medications.

 

Access the original article
Pease M, Mittal A, Merkaj S, et al. Early Seizure Prophylaxis in Mild and Moderate Traumatic Brain Injury: A Systematic Review and Meta-Analysis. JAMA Neurol. Published online April 08, 2024. doi:10.1001/jamaneurol.2024.0689

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