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• As brain injury severity increases, the period of time for which a survivor is
at risk of developing post- traumatic seizures also increases. (Patients with
moderate to severe TBI or penetrating TBI remain at increased risk for more than 5 years post
TBI.)
• Seizure recurrence: Individuals who develop seizures after the first week
following TBI have an ↑ chance of experiencing seizure recurrence;
seizures occurring immediately following TBI do not ↑the risk of
recurrence. (epileptogenesis vs direct brain insult)
Complications of post-traumatic seizures
1. Deterioration in cognitive and behavioural functioning.
2. Deterioration in overall functional status.
3. Negative impact on neurological recovery.
4. Status epilepticus
5. Mortality
Seizure Prevention or Prophylaxis
What evidence is there to support the prophylactic use of anticonvulsants after ABI?
-Level 1 evidence that anticonvulsants given during the first 24 hours post-
ABI reduce the occurrence of early seizures (within the first week post-
injury).
-Level 1 evidence that anticonvulsants given shortly after the onset of injury,
do not reduce mortality or persistent vegetative state or the occurrence of
late seizures (> one week post-injury).