S71. To study if Levetiracetam (Lev) is effective in reducing the incidence of Early Post Traumatic Seizures (EPTS) in 0–17 years old children with Closed Head Trauma (CHT)

Abstract

Introduction EPTS occur within seven days of the head trauma. Seizures occur in 10% of traumatic brain injury patients. 20% of people with CHT and intracranial bleeding (ICH) have EPTS. 25% patients will have another seizure after their first EPTS. Use of phenytoin to prevent EPTS is the current standard of care in the first seven days post head trauma. In the adult population, some studies have shown that Lev is effective in decreasing the frequency of EPTS. However, in the pediatric population, these studies are lacking. Methods We performed a retrospective chart review of patients admitted to our institution’s Pediatric Intensive Care Unit over a 5 year period, with a diagnosis of CHT. 38 patients were identified. Presence of ICH and incidence of EPTS was compared between 27 patients who received Lev and 11 patients who did not receive anti-epileptic drug (AED) treatment. Results Incidence of EPTS was 23.7% (9 of 38–7 after Lev, 2 without AED). Neither was there a significant difference (Chi Square p value ‘p’ = 0.45) in incidence of seizures in patients with Lev (7/27) compared to those without AED (2/11), nor in incidence of seizures in patients with ICH with lev (7/21) compared to those with ICH without AED (2/5) (p = 0.77). Conclusion In 0–17 year old children with CHT, with or without ICH, Lev does not significantly reduce the incidence of EPTS. Analyzing a larger number of patients may lend evidence supporting or refuting this conclusion.