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Use of Prophylactic Anticonvulsants in Neurologic Critical Care: A Critical Appraisal

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Abstract

Seizures are commonly encountered in the setting of brain injury in neurologic critical care. Though seizure prophylaxis with the use of antiepileptic drugs is frequently utilized in variety of brain injury paradigms, it is often not based on evidence and is controversial. Significant difficulties arise from interpretation of supporting literature due to lack of definitions for early-vs.-late-seizures, variable end points with seizure prophylaxis, as well as methodologic inconsistencies for seizure detection. This descriptive review summarizes the existing literature on the use of prophylactic anticonvulsants in clinical paradigms commonly encountered in neurologic critical care and highlights the important controversies concerning their use.

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Acknowledgments

Source of Support: This work was supported by Public Health Service NIH grant NS046379. The authors thank Tzipora Sofare, MA, for her editorial assistance in preparing this manuscript.

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Authors and Affiliations

  1. Department of Neurological Surgery, Oregon Health and Science University, Portland, OR, USA

    Kenneth C. Liu & Anish Bhardwaj

  2. Department of Neurology, Oregon Health and Science University, Mackenzie Hall, Room 2204, 3181 SW Sam Jackson Park Road, L-226, Portland, OR, 97239-3098, USA

    Anish Bhardwaj

  3. Department of Anesthesiology and Peri-Operative Medicine, Oregon Health and Science University, Portland, OR, USA

    Anish Bhardwaj

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  1. Kenneth C. Liu
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Correspondence to Anish Bhardwaj.

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Liu, K.C., Bhardwaj, A. Use of Prophylactic Anticonvulsants in Neurologic Critical Care: A Critical Appraisal. Neurocrit Care 7, 175–184 (2007). https://doi.org/10.1007/s12028-007-0061-5

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