Effects of Prophylactic Antiepileptic Drugs on Clinical Outcomes in Patients with a Good Clinical Grade Suffering from Aneurysmal Subarachnoid Hemorrhage.
10.7461/jcen.2015.17.3.166
- Author:
Seon Jin YOON
1
;
Jin Yang JOO
;
Yong Bae KIM
;
Chang Ki HONG
;
Joonho CHUNG
Author Information
1. Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. ns.joonho.chung@gmail.com
- Publication Type:Original Article
- Keywords:
Antiepileptic drug;
Clinical outcome;
Intracranial aneurysm;
Seizure;
Subarachnoid hemorrhage
- MeSH:
Aneurysm*;
Aneurysm, Ruptured;
Anticonvulsants*;
Follow-Up Studies;
Humans;
Intracranial Aneurysm;
Microsurgery;
Retrospective Studies;
Seizures;
Subarachnoid Hemorrhage*
- From:Journal of Cerebrovascular and Endovascular Neurosurgery
2015;17(3):166-172
- CountryRepublic of Korea
- Language:English
-
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 AND METHODS: 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.
