Association Between Prophylactic Anti‐Seizure Medication and Early Post‐Traumatic Seizures: An International Observational Multicenter Study

Evidence for the use of prophylactic anti-seizure medication (ASM) in traumatic brain injury (TBI) in reducing the occurrence of early post-traumatic seizure (EPTS) remains equivocal. This study aimed to analyze the prevalence of EPTS in children with TBI, compare clinical characteristics of those with and without EPTS, and explore the association between prophylactic ASM and EPTS. We performed an observational study among 28 pediatric intensive care units in 15 countries from January 2014 to October 2022. The rate of EPTS was compared between individuals prescribed prophylactic ASM and those who were not. Logistic regression was used to examine the association between ASM and EPTS. Among 697 children with TBI, 161 (23.1%) developed EPTS and 280 (40.2%) received prophylactic ASM treatment. Use of prophylactic ASM was associated with a lower likelihood of developing EPTS (27/280 (9.6%) vs. 134/417 (32.1%), <i>p</i> < 0.001). The most frequently used prophylactic ASMs were phenytoin, levetiracetam, and phenobarbital. Age ≤ 4 years and GCS ≤ 8 were associated with increased odds of developing EPTS (aOR 2.29, 95% CI 1.54-3.40, <i>p</i> < 0.001 and aOR 1.80, 95% CI 1.18-2.74, <i>p =</i> 0.01). Our data provide evidence supporting the potential protective role of prophylactic ASM against EPTS.

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Publication Details

Journal
MedComm
Published
2025-12-01
DOI
https://doi.org/10.1002/mco2.70524
Primary Topic
Traumatic Brain Injury and Neurovascular Disturbances
Type
article
Field-Weighted Citation Impact
0.00

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article

Association Between Prophylactic Anti‐Seizure Medication and Early Post‐Traumatic Seizures: An International Observational Multicenter Study

Rosa Elena de la Torre Gómez, Jesús Domínguez-Rojas, Hiroshi Kurosawa, Shu‐Ling Chong et al.
MedComm
Traumatic Brain Injury and Neurovascular Disturbances
article

Association Between Prophylactic Anti‐Seizure Medication and Early Post‐Traumatic Seizures: An International Observational Multicenter Study

Rosa Elena de la Torre Gómez, Jesús Domínguez-Rojas, Hiroshi Kurosawa, Shu‐Ling Chong, Sebastián González‐Dambrauskas, Chin Seng Gan, Jan Hau Lee, Natalia Elizabeth Gómez Arriola, Freddy Israel Pantoja Chamorro, J. Pilar Orive, Hongxing Dang, Paula Caporal, Nattachai Anantasit, Pei‐Chuen Lee, Yasser Kazzaz, Rujipat Samransamruajkit, Susana Reyes, Juan Camilo Jaramillo-Bustamante, Juan D. Roa G, Ivan J. Ardila, Rubén Eduardo Lasso Palomino, Marisol Fonseca Flores, Yek Kee Chor, Qalab Abbas, Adriana Yock‐Corrales, Deborah M. Turina, Meixiu Ming, Thelma Elvira Terán Miranda, Natalia Zita Watzlawik, Quan Wang, Jian Ji, Chun‐Feng Liu, Lawrence Chan, Suyun Qian, Jacqueline Soo May Ong, Gabriela Aparicio, Jane Pei Wen Ng
article en

Abstract

Evidence for the use of prophylactic anti-seizure medication (ASM) in traumatic brain injury (TBI) in reducing the occurrence of early post-traumatic seizure (EPTS) remains equivocal. This study aimed to analyze the prevalence of EPTS in children with TBI, compare clinical characteristics of those with and without EPTS, and explore the association between prophylactic ASM and EPTS. We performed an observational study among 28 pediatric intensive care units in 15 countries from January 2014 to October 2022. The rate of EPTS was compared between individuals prescribed prophylactic ASM and those who were not. Logistic regression was used to examine the association between ASM and EPTS. Among 697 children with TBI, 161 (23.1%) developed EPTS and 280 (40.2%) received prophylactic ASM treatment. Use of prophylactic ASM was associated with a lower likelihood of developing EPTS (27/280 (9.6%) vs. 134/417 (32.1%), <i>p</i> < 0.001). The most frequently used prophylactic ASMs were phenytoin, levetiracetam, and phenobarbital. Age ≤ 4 years and GCS ≤ 8 were associated with increased odds of developing EPTS (aOR 2.29, 95% CI 1.54-3.40, <i>p</i> < 0.001 and aOR 1.80, 95% CI 1.18-2.74, <i>p =</i> 0.01). Our data provide evidence supporting the potential protective role of prophylactic ASM against EPTS.

MedCommVol. 6(12)
University Malaya Medical Centre (MY), SingHealth (SG), Mexican Social Security Institute (MX), National University of Singapore (SG), Chinese University of Hong Kong (HK), Capital Medical University (CN), Universidad El Bosque (CO), Hospital Kuala Lumpur (MY), Garrahan Hospital (AR), Centro Hospitalario Pereira Rossell (UY), Sarawak General Hospital (MY), King Chulalongkorn Memorial Hospital (TH), Khoo Teck Puat Hospital (SG), Aga Khan University Hospital (PK), Universidad Columbia del Paraguay (PY), Hospital Nacional Cayetano Heredia (PE), King Abdullah International Medical Research Center (SA), SingHealth Duke-NUS Academic Medical Centre (SG), Fundación Valle del Lili (CO), Municipality of Medellín (CO), KK Women's and Children's Hospital (SG), Prince of Wales Hospital (CN), Hospital Civil de Guadalajara (MX), Clínica Santa María (CO), Kobe Children's Hospital (JP), Hospital Nacional de Niños (CR), Hospital de Cruces (ES), Hospital de Niños Superiora Sor María Ludovica (AR), Ramathibodi Hospital (TH), Universidad Autónoma del Paraguay (PY), Beijing Children’s Hospital (CN), National University Hospital (SG), Hospital Universitario Virgen de la Arrixaca (ES), Hospital del Niño (PA), Children's Hospital of Fudan University (CN), Children's Hospital of Chongqing Medical University (CN), Hospital Universitario Infantil San José (CO), Hospital General de Niños Ricardo Gutierrez (AR), Chongqing Medical University (CN), China Medical University (CN)
SingHealth Foundation, Medical Research Council, National Medical Research Council, Beijing Children's Hospital, Capital Medical University
Openalex Percentile: Top 46%
Traumatic Brain Injury and Neurovascular Disturbances
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