Tranexamic acid-associated seizures: Causes and treatment

Area of Science:

• Pharmacology
• Neurology
• Critical Care Medicine

Background:

• Antifibrinolytic drugs, including tranexamic acid, are widely used to manage hemorrhagic conditions.
• Tranexamic acid use is linked to a concerning rise in postoperative seizures.
• These seizures can lead to poor neurological outcomes, prolonged hospitalization, and increased mortality.

Purpose of the Study:

• To review the incidence, risk factors, and clinical presentation of seizures associated with tranexamic acid.
• To explore mechanistic insights from clinical and preclinical studies regarding these seizures.
• To enhance medical awareness and guide therapeutic interventions for tranexamic acid-induced seizures.

Main Methods:

• Literature review of clinical studies and preclinical research.
• Analysis of reported cases and experimental data on tranexamic acid and seizures.
• Synthesis of information on incidence, risk factors, clinical features, and potential mechanisms.

Main Results:

• Tranexamic acid is associated with an increased incidence of seizures.
• Specific patient populations and dosage regimens may heighten seizure risk.
• Mechanisms may involve GABAergic inhibition and excitatory pathways.

Conclusions:

• Clinicians need greater awareness of the seizure risk associated with tranexamic acid.
• Understanding risk factors and mechanisms can inform preventative and therapeutic strategies.
• Further research is needed to optimize the safe use of tranexamic acid.