Effects of Prophylactic Antiepileptic Drugs on Clinical Outcomes in Patients with a Good Clinical Grade Suffering from Aneurysmal Subarachnoid Hemorrhage
Journal of Cerebrovascular and Endovascular Neurosurgery
;
: 166-172, 2015.
Article
in English
| WPRIM
| ID: wpr-143012
ABSTRACT
OBJECTIVE:
Routine use of prophylactic antiepileptic drugs (AED) has been debated. We retrospectively evaluated the effects of prophylactic AED on clinical outcomes in patients with a good clinical grade suffering from aneurysmal subarachnoid hemorrhage (aSAH). MATERIALS ANDMETHODS:
Between September 2012 and December 2014, 84 patients who met the following criteria were included (1) presence of a ruptured aneurysm; (2) Hunt-Hess grade 1, 2, or 3; and (3) without seizure presentation. Patients were divided into two groups; the AED group (n = 44) and the no AED group (n = 40). Clinical data and outcomes were compared between the two groups.RESULTS:
Prophylactic AEDs were used more frequently in patients who underwent microsurgery (84.1%) compared to those who underwent endovascular surgery (15.9%, p < 0.001). Regardless of prophylactic AED use, seizure episodes were not observed during the six-month follow-up period. No statistical difference in clinical outcomes at discharge (p = 0.607) and after six months of follow-up (p = 0.178) were between the two groups. After six months, however, favorable outcomes in the no AED group tended to increase and poor outcomes tended to decrease.CONCLUSION:
No difference in the clinical outcomes and systemic complications at discharge and after six months of follow-up was observed between the two groups. However, favorable outcomes in the no AED group showed a slight increase after six months. These findings suggest that discontinuation of the current practice of using prophylactic AED might be recommended in patients with a good clinical grade.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Seizures
/
Subarachnoid Hemorrhage
/
Intracranial Aneurysm
/
Retrospective Studies
/
Follow-Up Studies
/
Aneurysm, Ruptured
/
Aneurysm
/
Microsurgery
/
Anticonvulsants
Type of study:
Observational study
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
Journal of Cerebrovascular and Endovascular Neurosurgery
Year:
2015
Type:
Article
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