Seizure prophylaxis is crucial since having an episode post TBI increases the risk for developing epilepsy.
Seizure prophylaxis is crucial since having an episode post TBI increases the risk for developing epilepsy. About half of patients with a severe TBI will have a seizure within 24 hours. Risk factors include decreased GCS, skull fractures, penetrating injuries, and retained material. Increased metabolic demands, increased intracranial pressure, compromised cerebral oxygen delivery, and excess neurotransmitter release.
Post traumatic seizures are classified under two categories; early is within 7 days, and late is after. Seizure prophylaxis is not beneficial and may do harm in late post traumatic seizures. Indications that warrants WIth early post traumatic seizure prophylaxis, there isn’t a preference on guideline recommended options, but fosphenyoin 17-20 mg/kg and levetiracetem 500 to 1000 mg or weightbased are reasonable agents. Levetiracetem seems more practical with most trauma patients since it can be given as an IV push and without concerns for DDI in the setting of limited information. Diggin the PHARMWYZE gear? Tag a friend below, and I’ll raffle off two hoodies next Friday to a pair of friends. Looking for more PHARMFAX? Check out another video on my page, share the PHARMFAX with a friend, and I hope you learned something new.
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