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Pharmacological Prophylaxis of Post-Traumatic Epilepsy

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Abstract

Early and late epileptic seizures are a frequent complication of severe head traumas. The administration of anticonvulsant drugs immediately after head injury is commonly implemented as a prophylactic measure; however, there is a lack of consensus on the usefulness of prophylaxis with anticonvulsants for the prevention of late post-traumatic epilepsy (PTE). The inconsistent evidence accumulated so far from clinical studies, most nonrandomised and uncontrolled in design, and the limited knowledge of the processes underlying post-traumatic epileptogenesis, do not warrant empirical pharmacological prophylaxis with long term administration of conventional anticonvulsants. Phenytoin and phenobarbital (phenobarbitone) are used to a large extent in this indication. As a general rule, a benefit/risk analysis in individual patients should drive prophylactic drug prescription in PTE as it can have potential detrimental effects on a patient’s recovery. New compounds, such as free-radical scavengers and antiperoxidants, show encouraging experimental results, but their clinical use is still very limited.

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  1. Department of Neurosciences, Section of Neurology, University of Pisa, via Roma 67, 56126, Pisa, Italy

    Alfonso Iudice & Luigi Muni

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Iudice, A., Muni, L. Pharmacological Prophylaxis of Post-Traumatic Epilepsy. Drugs 59, 1091–1099 (2000). https://doi.org/10.2165/00003495-200059050-00005

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