Pharmacological management of post-traumatic seizures in adults: current practice patterns in the UK and the Republic of Ireland.
Anti-epileptic medication
Post-traumatic seizures
Seizure prophylaxis
Traumatic brain injury
Journal
Acta neurochirurgica
ISSN: 0942-0940
Titre abrégé: Acta Neurochir (Wien)
Pays: Austria
ID NLM: 0151000
Informations de publication
Date de publication:
03 2019
03 2019
Historique:
received:
24
05
2018
accepted:
17
09
2018
pubmed:
3
10
2018
medline:
24
1
2020
entrez:
3
10
2018
Statut:
ppublish
Résumé
Patient selection for seizure prophylaxis after traumatic brain injury (TBI) and duration of anti-epileptic drug treatment for patients with early post-traumatic seizures (PTS), remain plagued with uncertainty. In early 2017, a collaborative group of neurosurgeons, neurologists, neurointensive care and rehabilitation medicine physicians was formed in the UK with the aim of assessing variability in current practice and gauging the degree of uncertainty to inform the design of future studies. Here we present the results of a survey of clinicians managing patients with TBI in the UK and Ireland. An online survey was developed and piloted. Following approval by the Academic Committee of the Society of British Neurological Surgeons, it was distributed via appropriate electronic mailing lists. One hundred and seventeen respondents answered the questionnaire, predominantly neurosurgeons (76%) from 30 (of 32) trauma-receiving hospitals in the UK and Ireland. Fifty-three percent of respondents do not routinely use seizure prophylaxis, but 38% prescribe prophylaxis for one week. Sixty percent feel there is uncertainty regarding the use of seizure prophylaxis, and 71% would participate in further research to address this question. Sixty-two percent of respondents use levetiracetam for treatment of seizures during the acute phase, and 42% continued for a total of 3 months. Overall, 90% were uncertain about the duration of treatment for seizures, and 78% would participate in further research to address this question. The survey results demonstrate the variation in practice and uncertainty in both described aspects of management of patients who have suffered a TBI. The majority of respondents would want to participate in future research to help try and address this critical issue, and this shows the importance and relevance of these two clinical questions.
Sections du résumé
BACKGROUND
Patient selection for seizure prophylaxis after traumatic brain injury (TBI) and duration of anti-epileptic drug treatment for patients with early post-traumatic seizures (PTS), remain plagued with uncertainty. In early 2017, a collaborative group of neurosurgeons, neurologists, neurointensive care and rehabilitation medicine physicians was formed in the UK with the aim of assessing variability in current practice and gauging the degree of uncertainty to inform the design of future studies. Here we present the results of a survey of clinicians managing patients with TBI in the UK and Ireland.
MATERIALS AND METHODS
An online survey was developed and piloted. Following approval by the Academic Committee of the Society of British Neurological Surgeons, it was distributed via appropriate electronic mailing lists.
RESULTS
One hundred and seventeen respondents answered the questionnaire, predominantly neurosurgeons (76%) from 30 (of 32) trauma-receiving hospitals in the UK and Ireland. Fifty-three percent of respondents do not routinely use seizure prophylaxis, but 38% prescribe prophylaxis for one week. Sixty percent feel there is uncertainty regarding the use of seizure prophylaxis, and 71% would participate in further research to address this question. Sixty-two percent of respondents use levetiracetam for treatment of seizures during the acute phase, and 42% continued for a total of 3 months. Overall, 90% were uncertain about the duration of treatment for seizures, and 78% would participate in further research to address this question.
CONCLUSION
The survey results demonstrate the variation in practice and uncertainty in both described aspects of management of patients who have suffered a TBI. The majority of respondents would want to participate in future research to help try and address this critical issue, and this shows the importance and relevance of these two clinical questions.
Identifiants
pubmed: 30276544
doi: 10.1007/s00701-018-3683-9
pii: 10.1007/s00701-018-3683-9
pmc: PMC6407744
doi:
Substances chimiques
Anticonvulsants
0
Levetiracetam
44YRR34555
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
457-464Subventions
Organisme : Department of Health
ID : II-C5-0715-20005
Pays : United Kingdom
Organisme : Department of Health
ID : 12/35/57
Pays : United Kingdom
Organisme : Medical Research Council
ID : G1002277
Pays : United Kingdom
Organisme : Department of Health
ID : HTA/13/15/02
Pays : United Kingdom
Organisme : Department of Health
ID : NIHR-RP-R3-12-013
Pays : United Kingdom
Organisme : Medical Research Council
ID : G0502030
Pays : United Kingdom
Organisme : Medical Research Council
ID : G9439390
Pays : United Kingdom
Organisme : Medical Research Council
ID : G0601025
Pays : United Kingdom
Organisme : Medical Research Council
ID : G0600986
Pays : United Kingdom
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