From concussion to control: Evaluating antiepileptic drug use in mild to moderate traumatic brain injury.

Abstract

Objective: To assess the effectiveness of prophylactic AEDs in preventing early and late post-traumatic seizures in patients with mild to moderate TBI. Study Design: Randomized Control Trial study. Setting: Department of Accident and Emergency, Farooq Hospital Islamabad. Period: March 2024 to September 2024. Methods: A total of sixty-two patients were selected from the department of Accident and Emergency with mild to moderate TBI (Glasgow Coma Scale [GCS] 9–15) admitted within 24 hours of head injury. Participants were divided into two groups: Group A (n=31) received prophylactic AEDs (levetiracetam 500 mg twice a day) for 7 days, while Group B (n=31) patients did not receive prophylaxis. Patients were followed for 7 days for early PTS and 3 months for late PTS. Data were analyzed using chi-square and independent sample t tests. Results: Post-traumatic seizure was common in both groups, affecting 3 patients (9.7%) in each. In Group A (prophylactic), all patients were improved and neurologically stable at discharge and after three months of follow-up. In group B (non-prophylactic), 28 (90.3%) patients were improved and neurologically stable at discharge and after three months of follow-up, while 3 (9.7%) patients had deteriorated and had mild neurological deficits. Conclusion: It was concluded that the overall incidence of post-traumatic seizure was low in mild to moderate traumatic brain injury. The incidence was similar for both prophylactic and non-prophylactic groups, with three patients in each group experiencing seizures.