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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.


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