Volume : X, Issue : IV, April - 2020

LEVETIRACETAM VERSUS PHENYTOIN FOR SEIZURE PROPHYLAXIS IN SEVERE TRAUMATIC BRAIN INJURY

Dr. Vimala Ambati, Dr. K. Jagadeesh Babu, Dr. Rohit Reddy Arumalla

Abstract :

Introduction: Seizure following traumatic ain injury (TBI) is a common complication that needs effective prevention to improve the outcome of TBI. For seizure prophylaxis, Phenytoin has been the only recommended antiepileptic drug (AED); however, several shortcomings have affected its use. Current standard of care for patients with severe traumatic ain injury (TBI) is prophylactic 7 days treatment with phenytoin to decrease the risk of early posttraumatic seizures. Phenytoin alters drug metabolism, induces fever, and requires therapeutic–level monitoring. Whereas, levetiracetam does not require serum monitoring or have significant pharmacokinetic interactions. In the current study, the authors compare the EEG findings in patients receiving phenytoin with those receiving levetiracetam monotherapy for seizure prophylaxis following severe TBI. Materials and Methods: The present study is conducted in Mamata medical college, Khammam, Telangana. Data were prospectively collected in 30 cases in which patients were treated with levetiracetam for the first 7 days after severe TBI and is compared with data from a historical cohort of 40 cases in which patients received phenytoin monotherapy. If patients displayed persistent coma, decreased mental status, or clinical signs of seizures they received 3–hour electroencephalographic (EEG) monitoring. Results: The EEG results were grouped into normal and abnormal findings. 15 of 30 patients in the levetiracetam group warranted EEG monitoring. In 7 of these 15 cases the results were normal and in 8 abnormal; 1 of the patients had seizure activity. 12 of 40 patients in the phenytoin group underwent EEG monitoring, with all results being normal. Conclusion: Patients treated with levetiracetam and phenytoin had equivalent incidence of seizure activity whereas patients receiving levetiracetam had a higher incidence of abnormal EEG findings.

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Article: Download PDF    DOI : 10.36106/ijar  

Cite This Article:

LEVETIRACETAM VERSUS PHENYTOIN FOR SEIZURE PROPHYLAXIS IN SEVERE TRAUMATIC BRAIN INJURY, Dr. VIMALA AMBATI, Dr. K. JAGADEESH BABU, Dr. ROHIT REDDY ARUMALLA INDIAN JOURNAL OF APPLIED RESEARCH : Volume-10 | Issue-4 | April-2020

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