The role of prophylactic anticonvulsants in moderate to severe head injury

Background Post-traumatic seizures cause secondary brain injury, contributing to morbidity and mortality after traumatic brain injury. Seizure activity may be undetectable if the patient is paralysed and ventilated. Aims The effect of prophylactic anticonvulsant therapy on the prevention of seizures after moderate to severe traumatic brain injury was studied. Methods A structured systematic literature review was performed. Results There may be a place for prophylactic anticonvulsants in the prophylaxis of early post-traumatic seizures. Conclusion Further randomised controlled trials are needed to firmly establish the benefits of prophylactic anticonvulsants. © Springer-Verlag London Ltd 2010.