Effect of levetiracetam and valproate on late-onset post-traumatic seizures

Background To compare the preventive effects of levetiracetam and valproate on late-onset post-traumatic seizures in patients with traumatic brain injury (TBI).Methods A total of 95 patients with TBI were recruited from 2017 to 2020. They were randomized into three groups: levetiracetam (LEV) group (n = 30) receiving LEV treatment (500 mg, bid, po); valproate group (n = 32) receiving sodium valproate (500 mg/d, once daily, po); and control group (n = 33) receiving no anti-seizure medication. LEV and valproate were given to corresponding groups within seven days after TBI, and the administration lasted for one month. The incidence of epilepsy and adverse events were evaluated at 7 days and 12 months post-TBI.Results The cumulative incidences of late post-traumatic seizures at the 12-month follow-up in the LEV, valproate, and control groups were 3.33%, 12.50% and 15.63%, respectively. The cumulative incidence of late post-traumatic seizures in the LEV group was significantly lower than those in the valproate and control groups (P < 0.05). The cumulative incidence of late post-traumatic seizure in the valproate group was not significantly different from that in the control group (P > 0.05).Conclusions LEV can reduce the cumulative incidence of late post-traumatic seizures, whereas valproate can not.