Imperial College London
Portrait Picture

Professor Mark Wilson

Faculty of Medicine, Department of Surgery & Cancer

Professor of Practice
 
 
 
//

Contact

 

+44 (0)20 7594 1532m.wilson

 
 
//

Location

 

Cambridge WingSt Mary's Campus

//

Summary

 

Publications

Citation

BibTex format

@article{Harris:2020:10.1007/s00415-020-09769-5,
author = {Harris, L and Hateley, S and Tsang, KT and Wilson, M and Seemungal, BM},
doi = {10.1007/s00415-020-09769-5},
journal = {Journal of Neurology},
pages = {1774--1779},
title = {Impact of anti-epileptic drug choice on discharge in acute traumatic brain injury patients},
url = {http://dx.doi.org/10.1007/s00415-020-09769-5},
volume = {267},
year = {2020}
}
Download

RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundAnti-epileptic drug (AED) prophylaxis in the first-seven days post-traumatic brain injury (TBI) is known to reduce seizure frequency acutely. AED efficacy is equivalent; therefore, choice of AED may rest with their side-effects. We hypothesise that AEDs that impair balance will prolong recovery, shown by a longer hospital stay. We compared length of hospital stay (and reported dizziness) in TBI patients receiving the commonest AEDs used in our TBI patients, Phenytoin (which may cause imbalance), and Levetiracetam (which does not affect balance).MethodA retrospective observational study was performed on TBI patients admitted to a Major Trauma Unit between October 2013 and June 2018. 100 of 278 patients treated with phenytoin or levetiracetam monotherapy for seizure prophylaxis were included. The inclusion criteria of admission Glasgow Coma Score of 14 or more and length of stay less than 3 weeks minimised confounding variables such as non-ambulant patients. Length of hospital stay and incidence of dizziness were assessed.ResultsThe length of hospital stay was longer for patients on Phenytoin versus Levetiracetam, i.e., 10.74 vs. 7.58 days (p = 0.015; unpaired, two-sided t test). Dizziness reported by patients on phenytoin was 24% and levetiracetam was 8% (p = 0.018; Chi-squared test).ConclusionIn this cohort, using Phenytoin for acute TBI, seizure prophylaxis was associated with longer length of stay and more dizziness compared to Levetiracetam. Given their equivalent AED efficacy in acute TBI seizure prophylaxis, our data suggest that Levetiracetam is preferable to Phenytoin for early seizure prophylaxis in TBI. This requires evaluation in larger, prospective studies.
AU  - Harris,L
AU  - Hateley,S
AU  - Tsang,KT
AU  - Wilson,M
AU  - Seemungal,BM
DO  - 10.1007/s00415-020-09769-5
EP  - 1779
PY  - 2020///
SN  - 0340-5354
SP  - 1774
TI  - Impact of anti-epileptic drug choice on discharge in acute traumatic brain injury patients
T2  - Journal of Neurology
UR  - http://dx.doi.org/10.1007/s00415-020-09769-5
UR  - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000540157500024&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - https://link.springer.com/article/10.1007/s00415-020-09769-5
UR  - http://hdl.handle.net/10044/1/99364
VL  - 267
ER  -
Download