Abstract:
We aim to assess the effect of anti-epileptic drug (AED) prophylaxis for early or late posttraumatic seizures, targeting the pediatric population with traumatic brain injury (TBI). We systematically searched for studies reporting the incidence of posttraumatic seizures in pediatric patients who suffered from TBI and received AEDs prophylactically following their TBI incident. Studies that included adult patients, adult and pediatric patients but did not report results for the pediatric population separately, and patients who did not suffer from a TBI were excluded. Studies that did not indicate the use of antiepileptic drugs prophylactically following TBI were excluded. A total of 10 studies were included involving 4621 posttraumatic brain injury patients of the pediatric age population (<18). Five studies assessed the effect of prophylaxis on early seizures, four on late seizures and one on any seizure. The mean incidence of posttraumatic seizures with AED prophylaxis was 8% for early seizures and 7.1% for late seizures. Moreover, one study revealed no benefit of AED prophylaxis for early posttraumatic seizures. Meta-analysis revealed a significant difference in the incidence of early posttraumatic seizures with antiepileptic prophylaxis. However, no significant difference for late posttraumatic seizures has been shown. In conclusion, AED prophylaxis seems to be effective against early posttraumatic seizures for the pediatric population, with levetiracetam possibly being more effective. Also, there is no observed benefit for late posttraumatic seizures.
摘要:
我们的目的是评估抗癫痫药物(AED)预防早期或晚期创伤后癫痫发作的效果。针对患有创伤性脑损伤(TBI)的儿科人群。我们系统地搜索了报告患有TBI并在TBI事件后预防性接受AED的儿科患者创伤后癫痫发作发生率的研究。包括成年患者的研究,成人和儿科患者,但没有单独报告儿科人群的结果,未患有TBI的患者被排除在外.未表明在TBI后预防性使用抗癫痫药物的研究被排除。共纳入10项研究,涉及4621名儿童年龄(<18)的创伤性脑损伤后患者。五项研究评估了预防对早期癫痫发作的影响,四个是晚期癫痫发作,一个是任何癫痫发作。AED预防的创伤后癫痫的平均发生率为早期癫痫发作的8%和晚期癫痫发作的7.1%。此外,一项研究显示,AED预防对创伤后早期癫痫发作没有益处.荟萃分析显示,预防抗癫痫的早期创伤后癫痫发作的发生率存在显着差异。然而,创伤后晚期癫痫发作没有显着差异。总之,AED预防似乎对儿科人群的早期创伤后癫痫发作有效,左乙拉西坦可能更有效。此外,创伤后晚期癫痫发作没有观察到的益处.