Summary

 

  1. There is Level 1b evidence to suggest that levetiracetam is as safe and effective as phentoin in the treatment and prevention of early seizures in individuals in the intensive care unit post ABI.
     
  2. There is Level 1b evidence that anticonvulsants given during the first 24 hours post ABI reduce the occurrence of early seizures (within the first week post injury).
     
  3. There is Level 1a evidence that seizure prophylactic treatment with either phenytoin or valproate results in similar incidences of early or late seizures and similar mortality rates.
     
  4. There is Level 1a evidence that seizure prophylactic treatment with either phenytoin or valproate results in similar incidences of early or late seizures and similar mortality rates.
     
  5. There is Level 2 evidence that glucocorticoid exposure after brain injury is not associated with a decrease in late seizures, and early exposure (within 1 day post injury) is associated with seizure activity.
     
  6. There is Level 4 evidence that methylphenidate for the treatment of cognitive and behavioral problems can be safely used in brain injured patients at risk for post-traumatic seizures as it is not associated with an increase in seizure frequency
     
  7. There is Level 4 evidence that acute intramuscular Midazolam can be used for acute seizure cessation.
     
  8. There is Level 2 evidence indicating that phenobarbital given post ABI does not reduce the risk of late seizures.
     
  9. There is Level 4 evidence that a subgroup of ABI patients (those where the seizure focus can be accurately localized) would benefit from surgical resection for post-traumatic seizures.
     
  10. There is Level 4 evidence that extratemporal resection is effective in controlling post-traumatic epilepsy.