TBI-SEIZURES, EARLY

SUMMARY

1. Defined by their occurrence ≤ 1 week of TBI, acute symptomatic events that are not felt to represent epilepsy.

2. Phenytoin is often used because it does not cause significant sedation and can be loaded IV, Levetiracetam is an alternative.

3. The optimal duration of therapy is not clear and depends upon the severity of injury, usually continued throughout the hospital stay and are gradually withdrawn within the first few weeks.

4. Risk factors: intracranial hematoma, depressed skull fracture, severe injury, and in young children.

5. Short-term use of anti-seizure drugs is recommended for the prevention of early seizures in patients who are at high risk & in whom seizures present a threat because of elevated ICP, systemic injury, or other reason (Grade 1B).

Reference(s)

Cifu, D.X. (2020). Braddom’s physical medicine and rehabilitation. Elsevier. Get it on Amazon.
Cuccurullo, S. (2019). Physical medicine and rehabilitation board review. New York: Demosmedical. Get it on Amazon.
O’Young, B., Young, M.A. and Stiens, S.A. (2008). Physical Medicine and Rehabilitation Secrets. Mosby. Get it on Amazon.