Antiepileptic Drugs for Patients with Intracerebral Hemorrhage: A Meta-Analysis

Whether an antiepileptic drug (AED) should be prescribed for intracerebral hemorrhage (ICH) patients is a matter in dispute, and recent studies have come up with different or even opposite views. A meta-analysis on this issue has not been performed. The goal of this meta-analysis was to study antiepileptic drugs" effects on early seizure occurrence and outcome for ICH patients.

We searched the PubMed, Ovid, and Cochrane library until December 2015 to identify relevant articles. A meta-analysis was conducted to evaluate the overall effect with random-effects or fixed-effects models.

Four articles consisting of one randomized controlled trial and three cohort studies met the included criteria. For the occurrence of early seizure, antiepileptic drugs showed the ability to reduce the risk, but reached no statistical significance (OR=0.71; 95% CI, 0.38-1.34; test for overall effect Z=1.06, p=0.29). No association between antiepileptic drug use and poor outcome was found (OR=1.95; 95% CI, 0.56-6.79; test for overall effect Z=1.06, P=0.29), but heterogeneity was present.

Summarizing published studies, the AED use did not reduce early seizure occurrence statistically but a population with high-risk factors of early seizure is likely to benefit from AEDs. Besides, AED use was not associated with poor outcome. We suggest AED use for ICH patients with high-risk factors of seizure, but not generally.