Anti-epileptic Prophylaxis for Early or Late Post-traumatic Seizures in Children with Traumatic Brain Injury: A Systematic Review (P13-1.009)

Abstract

<h3>Objective:</h3> We aim to assess the effect of anti-epileptic drug, “AED”, prophylaxis for early or late post traumatic seizures, targeting the pediatric age population with traumatic brain injury, “TBI”. <h3>Background:</h3> Traumatic brain injury is one of the known causes of seizures. There have been several studies investigating the benefit of AED prophylaxis for early and late post traumatic seizures. However, not many discussed that for the pediatric population, exclusively. <h3>Design/Methods:</h3> We systematically searched for studies reporting the incidence of posttraumatic seizures in pediatric patients who suffered from TBI and received AEDs prophylactically following their TBI incident. Studies that included adult patients, adult and pediatric patients but did not report results for the pediatric population separately and patients who did not suffer from a TBI, were excluded. Studies that did not indicate the use of antiepileptic drugs prophylactically following TBI were excluded. <h3>Results:</h3> A total of 10 studies were included involving 4621 post traumatic brain injury patients of the pediatric age population (&lt;18). The majority of the studies included Levetiracetam or Phenytoin as AED prophylaxis for post traumatic seizures. Five studies assessed the effect of prophylaxis on early seizures, 4 on late seizures, and 1 on any seizure. The mean incidence of early post traumatic seizures with AED prophylaxis was 8%. Moreover, one study revealed no benefit of AED prophylaxis for early post traumatic seizures. Regarding late post traumatic seizures, the average incidence with AED prophylaxis was 7.1%. However, no studies demonstrated a benefit of AED prophylaxis. Additionally, one study showed a lower incidence of post traumatic seizures with Levetiracetam prophylaxis (37%) than Phenytoin (41%). <h3>Conclusions:</h3> In conclusion, AED prophylaxis seems to be effective against early post traumatic seizures for the pediatric population, with Levetiracetam possibly being more effective. Also, there is no observed benefit for late post traumatic seizures. <b>Disclosure:</b> Dr. Al Jayyousi has nothing to disclose. Dr. Hazaimeh has nothing to disclose. Mr. Freitekh has nothing to disclose. Ms. Sawan has nothing to disclose. Dr. Jbarah has nothing to disclose.