Assessing risk factors associated with breakthrough early post-traumatic seizures in patients receiving phenytoin prophylaxis

• DOI: 10.3389/fneur.2023.1329042
• Publication Date: 2024-01-04T14:37:06Z
• Authors: Eugene Generoso; Calvin Diep; Carolyn Hua; Elizabeth Rader; Ran Ran; Nathanael J. Lee; Lucia Rivera-Lara
• Keywords: 03 medical and health sciences; 0302 clinical medicine; Neurology; traumatic brain injury; phenytoin; post-traumatic epilepsy; risk factors; seizure prophylaxis; Neurology (clinical); Neurology. Diseases of the nervous system; RC346-429

Objective Post-traumatic seizure (PTS) is a well-known complication of traumatic brain injury (TBI). The objective this study was to identify risk factors associated with breakthrough early PTS in TBI patients receiving phenytoin prophylaxis. Methods This single-centered retrospective including adult admitted the intensive care unit (ICU), had TBI, and started on for prophylaxis within 24 h admission. primary outcome incidence PTS, defined as confirmed continuous electroencephalogram 7 days TBI. Secondary outcomes included association between post-traumatic seizures ICU length stay, hospital in-hospital mortality. Results A total 105 were final analysis. Patients older (65 vs. 48 years old, p = 0.01), higher Marshall score (5 2, more likely have > 2 (73 37%, neurosurgeries hematoma evacuation (57 19%, 0.01). In 57% level at time seizure, those, 87.5% therapeutic (>10 mcg/mL). longer stay (14.7 5.9 days, 0.04) greater proportion mortality (21 2%, 0.02). Conclusion age, score, neurosurgical procedures incidences despite use majority levels when available; however, approximately half (43%) did not level.