Gul Nasim, Khan Shahbaz Ali, Khattak Haider Ali, Muhammad Gul, Khan Abdul Aziz, Khan Ibrahim, Aurangzeb Ahsan
Department of Neurosurgery, Ayub Medical College, Abbottabad, Pakistan.
J Ayub Med Coll Abbottabad. 2019 Apr-Jun;31(2):237-241.
The use of anti-epileptic drugs for prophylaxis of early post-traumatic seizures after traumatic brain injury has been very promising. The objective of this study was to determine the outcome of phenytoin in prevention of early post-traumatic seizures in moderate to severe traumatic brain injuries and to compare the frequency of seizures in moderate to severe traumatic brain injury, with phenytoin started within 12 hours and after 12 hours of injury.
This cross-sectional study was conducted at Department of Neurosurgery, Ayub Medical Institute, Abbottabad from April to October, 2015. All the patients with moderate to severe head injury presenting within 48 hours of injury were included in this study in consecutive manner. Patients were started on phenytoin and observed for early post-traumatic seizures.
A total of 163 patients were included in this study with a mean age of 24.69±10.186 years. One hundred and twenty-two (74.8%) were males and rest of 41 (25.2%) were females. A total of 26 (16%) patients had early post-traumatic seizures. 9.89% patients in whom phenytoin was started within 12 hours had seizures, while 23.11% patients in whom phenytoin was started after 12 hours of injury had seizures, the difference being statistically significant (p-value .018)..
Frequency of early post-traumatic seizures is high in patients with moderate to severe head injured patients. Anti-epileptics like phenytoin should be started within 12 hours for seizure prophylaxis.
使用抗癫痫药物预防创伤性脑损伤后的早期创伤后癫痫发作前景十分广阔。本研究的目的是确定苯妥英钠在预防中度至重度创伤性脑损伤早期创伤后癫痫发作中的效果，并比较在受伤后12小时内及12小时后开始使用苯妥英钠的中度至重度创伤性脑损伤患者的癫痫发作频率。
本横断面研究于2015年4月至10月在阿伯塔巴德阿尤布医学院神经外科进行。所有在受伤后48小时内出现中度至重度头部损伤的患者均连续纳入本研究。患者开始使用苯妥英钠并观察早期创伤后癫痫发作情况。
本研究共纳入163例患者，平均年龄为24.69±10.186岁。其中122例（74.8%）为男性，其余41例（25.2%）为女性。共有26例（16%）患者出现早期创伤后癫痫发作。在受伤后12小时内开始使用苯妥英钠的患者中，9.89%出现癫痫发作，而在受伤12小时后开始使用苯妥英钠的患者中，23.11%出现癫痫发作，差异具有统计学意义（p值为0.018）。
中度至重度头部受伤患者早期创伤后癫痫发作的频率较高。应在12小时内开始使用苯妥英钠等抗癫痫药物进行癫痫预防。
