Anesthesia Considerations 

Seizure prophylaxis

 

• Early post-traumatic seizures (PTS) = w/in 7 days of injury

  • Not a/w worse outcomes

• Late PTS = after 7 days of injury

• Post-traumatic epilepsy (PTE) = recurrent seizures >7 days after injury

• Recommendations:

  • Prophylactic phenytoin or valproate not recommended to prevent late PTS

  • Phenytoin recommended to ↓ early PTS (when benefit > risk)

  • Insufficient evidence to recommend levetiracetam over phenytoin

 

 

Adapted from Guidelines for the Management of Severe TBI, 4th Ed., September 2016, Brain Trauma Foundation.