2015, Number 2
<< Back Next >>
Investigación en Discapacidad 2015; 4 (2)
Frequency of seizures after acquired brain injury and the use of antiepileptic drugs. A pilot study
Fimbres-García G, Acuña-López H, Montijo-Muñoz G, Rodríguez-Fabián S, Martín del Campo-Arias S, Carrillo-Santos M, Hernández-Arenas C, Carrillo-Mora P
Language: Spanish
References: 29
Page: 71-77
PDF size: 143.63 Kb.
ABSTRACT
Introduction: The reported frequency of seizures after a traumatic brain injury (TBI) or stroke is highly variable depending on the population studied. Diverse antiepileptic drugs (AEDs) are prescribed as prophylactic treatment; however, the optimal duration of this therapy is unknown. Furthermore, it has recently been shown that some AEDs may have a negative effect on neuroplasticity processes.
Objective: Given the potential negative effects of the indiscriminate use of AEDs, the aim of this pilot study was to determine the frequency of post-injury crisis and chronic use of AEDs in a sample of patients with sequelae of TBI or stroke.
Methodology: A survey was applied in 100 patients with sequelae of acquired brain injury (stroke or TBI) to harvest information about their brain injury, the presence of seizures and AEDs use.
Results: A total of 100 patients, 80 with stroke and 20 with TBI, were included. The overall frequency of seizures in the sample was 20%, being more common after hemorrhagic stroke (21%) and TBI (25%); most cases of seizures were of late presentation (75%); 36% of patients were currently taking AEDs; however, 61% of them had never presented seizures. Phenytoin is the most commonly prescribed drug (40%).
Conclusions: A high frequency of post-injury seizures and current use of AEDs was observed; additionally, a high frequency of unjustified use of AEDs was noticed.
REFERENCES
Langlois JA, Rutland-Brown W, Wald MM. The epidemiology and impact of traumatic brain injury: a brief overview. J Head Trauma Rehabil. 2006; 2: 375-378.
Carrillo-Mora P. Situación actual del tratamiento y la rehabilitación de las lesiones cerebrales adquiridas en adultos. Rev Invest Discapacidad. 2014; 3: 190-193.
Signoretti S, Vagnozzi R, Tavazzi B, Lazzarino G. Biochemical and neurochemical sequelae following mild traumatic brain injury: summary of experimental data and clinical implications. Neurosurg Focus. 2010; 29: E1.
Asikainen I, Kaste M, Sarna S. Early and late posttraumatic seizures in traumatic brain injury rehabilitation patients: brain injury factors causing late seizures and influence of seizures on long-term outcome. Epilepsia. 1998; 40: 584-589.
Frey LC. Epidemiology of posttraumatic epilepsy; a critical review. Epilepsia. 2003; 44: 11-17.
Zhao Y, Wu H, Wang X, Li J, Zhang S. Clinical epidemiology of posttraumatic epilepsy in a group of Chinese patients. Seizure. 2012; 21: 322-326.
Wang H, Xin T, Sun X, Wang S, Guo H, Holton-Burke C et al. Post-traumatic seizures –a prospective, multicenter, large case study after head injury in China. Epilepsy Res. 2013; 107: 272-278.
Paolucci S, Silverstri G, Lubich S et al. Post stroke late seizures and their role in rehabilitation of inpatients. Epilepsia. 1997; 38: 266-270.
Jungehulsing GJ, Heuschmann PU, Holtkamp M, Schwab S, Kolominsky-Rabas PL. Incidence and predictors of post-stroke epilepsy. Acta Neurol Scand. 2013; 127: 427-430.
Hesdorffer DC, Benn EK, Cascino GD, Hauser WA. Is a first acute symptomatic seizure epilepsy? Mortality and risk for recurrent seizure. Epilepsia. 2009; 50: 1102-1108.
Cesnik E, Casetta I, Granieri E. Post-traumatic epilepsy: review. J Neurol Neurophysiol. 2013; S2: 009. doi: 10.4172/2155-9562.S2-009.
Myint PK, Staufenberg EFA, Sabanathan K. Post-stroke seizure and post-stroke epilepsy. Postgrad Med J. 2006; 82: 568-572.
Chang BS, Lowenstein DH. Practice parameter: antiepileptic drug prophylaxis in severe traumatic brain injury: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2003; 60: 10-16.
Adams HP Jr, del Zoppo G, Alberts MJ, Bhatt DL, Brass L, Furlan A et al. Guidelines for the early management of adults with ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council. Stroke. 2007; 38: 1655-1711.
Bratton SL, Chestnut RM, Ghajar J, McConnell-Hammond FF, Harris OA et al. Guidelines for the management of severe traumatic brain injury. XIII. Antiseizure prophylaxis. J Neurotrauma. 2007; 24 Suppl 1: S83-S86.
Morgenstern LB, Hemphill JC 3rd, Anderson C, Becker K, Broderick JP, Connolly ES Jr et al. Guidelines for the management of spontaneous intracerebral hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2010; 41: 2108-2129.
Steiner T, Al-Shahi-Salman R, Beer R, Christensen H, Cordonnier C, Csiba L et al. European Stroke Organization (ESO) guidelines for the management of spontaneous intracerebral hemorrhage. Int J Stroke. 2014; 9: 840-855.
Rosengart AJ, Huo JD, Tolentino J, Novakovic RL, Frank JI, Goldenberg FD et al. Outcome in patients with subarachnoid hemorrhage treated with antiepileptic drugs. J Neurosurg. 2007; 107: 253-260.
Bhullar IS, Johnson D, Paul JP, Kerwin AJ, Tepas JJ 3rd, Frykberg ER. More harm than good: antiseizure prophylaxis after traumatic brain injury does not decrease seizure rates but may inhibit functional recovery. J Trauma Acute Care Surg. 2014; 76: 54-60.
Agrawal A, Timothy J, Pandit L, Manju M. Post-traumatic epilepsy: an overview. Clin Neurol Neurosurg. 2006; 108: 433-439.
Chen TC, Chen YY, Cheng PY, Lai CH. The incidence rate of post-stroke epilepsy: a 5-year follow-up study in Taiwan. Epilepsy Res. 2012; 102: 188-194.
Salazar AM, Jabbari B, Vance SC, Grafman J, Amin D, Dillon JD. Epilepsy after penetrating head injury. I. Clinical correlates: a report of the Vietnam head injury study. Neurology. 1985; 35: 1406-1414.
Rocha RL, Lopez-Meraz ML, Niquet J, Wasterlain CG. Do single seizures cause neuronal death in the human hippocampus? Epilepsy Curr. 2007; 7: 77-81.
Huff JS, Melnick ER, Tomaszewski CA, Thiessen ME, Jagoda AS, Fesmire FM. Clinical policy: critical issues in the evaluation and management of adult patients presenting to the emergency department with seizures. Ann Emerg Med. 2014; 63: 437-447.
Goldstein LB. Prescribing of potentially harmful drugs to patients admitted to hospital after head injury. J Neurol Neurosurg Psychiatry. 1995; 58: 753-755.
Naidech AM, Kreiter KT, Janjua N, Ostapkovich N, Parra A, Commichau C et al. Phenytoin exposure is associated with functional and cognitive disability after subarachnoid hemorrhage. Stroke. 2005; 3: 583-587.
Nadeau SE, Lu X, Dobkin B, Wu SS, Dai YE, Duncan PW. A prospective test of the late effects of potentially antineuroplastic drugs in a stroke rehabilitation study. Int J Stroke. 2014; 9: 449-456.
Teasell RW, McRae MP. Poststroke seizures in stroke rehabilitation patients. J Stroke Cerebrovasc Dis. 1999; 8: 84-87.
Goldstein LB. Potential effects of common drugs on stroke recovery. Arch Neurol. 1998; 55: 454-456.