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Traumatic Brain Injury and Seizures in the ICU

  • Chapter
Seizures in Critical Care

Part of the book series: Current Clinical Neurology ((CCNEU))

Abstract

Seizures may occur in up to 22% of patients in the intensive care unit with severe traumatic brain injury. There is a relatively high risk of nonconvulsive seizures in this population. Seizures may exacerbate the injury process and disrupt both patient care and family coping. Therefore, seizures should be recognized quickly and treated promptly. The clinician should have a high index of suspicion for seizures, especially in patients with clearly defined risk factors for seizure development. Continuous electroencephalogram monitoring should be considered in patients who are considered to be at high risk of clinical or subclinical seizures. Seizure prophylaxis with antiepileptics is supported by the literature for the prevention of early seizures (defined as <7 d postinjury) but not for late seizures. Phenytoin and carbamazepine have been used in this setting, and both were efficacious in preventing early seizures. Phenytoin has several features that make it a best first-line agent. Anticonvulsants have not been found to reduce the incidence of developing late posttraumatic seizures, and, therefore, prolonged prophylaxis with antiepileptics is not currently supported.

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  1. Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI

    Andrew Beaumont MD, PhD & Grant Sinson MD

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  1. Andrew Beaumont MD, PhD
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  1. Neurointensive Care Unit, and Department of Neurology, Medical College of Wisconsin, Milwaukee, WI

    Panayiotis N. Varelas MD, PhD

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Beaumont, A., Sinson, G. (2005). Traumatic Brain Injury and Seizures in the ICU. In: Varelas, P.N. (eds) Seizures in Critical Care. Current Clinical Neurology. Humana Press. https://doi.org/10.1007/978-1-59259-841-0_3

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  • DOI: https://doi.org/10.1007/978-1-59259-841-0_3

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