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Association Between Prophylactic Anti-Seizure Medication and Early Post-Traumatic Seizures: An International

Jian Ji1, Juan D Roa G2, Shu-Ling Chong3

  • 1Pediatric Intensive Care Unit Beijing Children's Hospital Capital Medical University National Center for Children's Health Beijing China.

Medcomm
|December 15, 2025
PubMed

Insights

Prophylactic anti-seizure medication (ASM) may reduce early post-traumatic seizures (EPTS) in children with traumatic brain injury (TBI). This study found ASM use was linked to a lower EPTS occurrence, suggesting a protective effect.

Area of Science:

  • Neurology
  • Pediatric Critical Care
  • Clinical Pharmacology

Background:

  • Early post-traumatic seizures (EPTS) are a concern in pediatric traumatic brain injury (TBI).
  • The efficacy of prophylactic anti-seizure medication (ASM) in preventing EPTS after TBI is not well-established.
  • Understanding EPTS prevalence and risk factors in children with TBI is crucial for guiding treatment strategies.

Purpose of the Study:

  • To determine the prevalence of EPTS in pediatric TBI patients.
  • To compare clinical characteristics between children with and without EPTS.
  • To investigate the association between prophylactic ASM use and the occurrence of EPTS in pediatric TBI.

Main Methods:

  • An observational study was conducted across 28 pediatric intensive care units in 15 countries.
  • Data were collected from January 2014 to October 2022, involving 697 children with TBI.
  • Logistic regression analysis was used to assess the relationship between prophylactic ASM and EPTS, controlling for relevant factors.

Main Results:

  • The overall incidence of EPTS was 23.1% (161/697) among children with TBI.
  • Prophylactic ASM was administered to 40.2% (280/697) of the patients.
  • ASM use was significantly associated with a reduced likelihood of EPTS (9.6% vs. 32.1%, p < 0.001).
  • Younger age (≤ 4 years) and lower Glasgow Coma Scale scores (≤ 8) were risk factors for EPTS.
  • Phenytoin, levetiracetam, and phenobarbital were the most common prophylactic ASMs.

Conclusions:

  • Prophylactic ASM use demonstrated a potential protective role against EPTS in pediatric TBI.
  • The findings support the consideration of prophylactic ASM in managing children with TBI.
  • Further research may refine guidelines for ASM use in this population.

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