Evaluation of levetiracetam for early post-traumatic seizure prophylaxis: A level II trauma center experience

• Published in: The surgeon (Edinburgh) 2023-04, Vol.21 (2), p.e78-e82
• Main Authors: Amin, Timothy A., Nerenberg, Steven F., Elsawy, Osama A., Wang, Antai, Johnston, Jackie P.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anticonvulsants - therapeutic use; Antiepileptic; Epilepsy, Post-Traumatic - drug therapy; Female; Humans; Levetiracetam - therapeutic use; Male; Middle Aged; Piracetam - therapeutic use; Retrospective Studies; Seizure; Trauma; Trauma Centers; Traumatic brain injury
• ISSN: 1479-666X; 2405-5840
• DOI: 10.1016/j.surge.2022.05.001

Traumatic brain injury (TBI) can induce early or late post-traumatic seizures (PTS). While PTS incidence is low, prophylaxis is used despite a lack of consensus on agent or duration. Levetiracetam (LEV) for early PTS prophylaxis is preferred due to its safety and efficacy. The purpose of this study was to evaluate LEV for early PTS prophylaxis. A single-center, retrospective chart review of TBI patients ≥18 years who received LEV for early PTS prophylaxis between August 2018–July 2019. The primary outcome was LEV duration. Secondary outcomes were incidence of seizure, intensive care unit (ICU) and hospital length of stay (LOS). Of the 137 included, mean age was 59 ± 20 years and 69.3% were male. The mean admission GCS was 13 ± 4 and 77.4% had mild TBI. Median LEV duration was 7 (IQR 4–10) days and 13.9% met recommended 7-day duration. Those prescribed LEV >7 days had more than twice the median LEV duration than those prescribed ≤7 days [10.25 (8.5–15.5) vs 4 (1.5–4.5) days, p