Efficacy of Anticonvulsant Administration as Seizure Prophylactic Therapy in Traumatic Brain Injury Patients

Abstract

Traumatic brain injury (TBI) is a non-degenerative, non-congenital disorder of the brain that occurs due to external mechanics that can cause permanent or temporary impairment of cognitive, physical and psychosocial functions. Based on the 2018 Basic Health Research (Riskesdas) data, the prevalence of head injuries in Indonesia is 11.9%. Seizures after head injury result in secondary brain damage and seizure prophylaxis is only recommended in patients with TBI during the first seven days. This study was designed to assess the efficacy of anticonvulsants as prophylactic therapy in patients with TBI in Indonesia. The research method used was a literature review that was searched using Google Scholar, Pubmed, Medline, Ebsco, Hindawi, ScienceDirect, and Cochrane, published in the last ten years. After obtaining the appropriate literature, the manuscript is written. The results showed that prophylactic anticonvulsants such as Phenytoin could reduce the incidence of early posttraumatic seizures (PTS) in patients with TBI compared to placebo. Another study also stated that giving anticonvulsants (Carbamazepine, Phenobarbital, Phenytoin, Levetiracetam and Valproate) in preventing early PTS showed effective results in TBI when compared to placebo. So, it can be concluded, based on the literature search conducted, anticonvulsants are proven to be able to prevent PTS, with the recommendation of drug choice being Phenytoin.