Abstract
Chronic subdural hematoma (CSH) is an accumulation of blood within the intracranial subdural space. It is associated with minor traumatic events and affects mostly the elderly. CSH can be effectively treated surgically with good outcomes, although the recurrence rate is high. Epileptic seizures are one of the major complications associated with CSH, either in the pre or postoperative period. The incidence rate of new onset seizures after CSH diagnosis ranges between 3% and 23%. However, the benefit of using prophylactic antiepileptic drugs in these patients is controversial with significant variations in clinical practice. It ranges from routine to total absence of use in this clinical context. The best current evidence does not allow any firm conclusion on whether such prophylactic treatment is effective, that is if it prevents the development of epileptic seizures. Furthermore, these drugs are associated with important adverse events. A systematic literature review found no controlled randomized trials evaluating the risk/benefit of the prophylactic use of anticonvulsants for people with CSH and retrospective studies showing contradictory results. Moreover, these observational studies are outdated and do not evaluate new generation drugs. Herein, we discuss the evidence for the use of antiepileptic drugs for preventing seizures in patients with CSH, with a particular focus on the subgroup of people most likely to benefit (such as the elderly and alcohol abusers), as well as the possible safety advantages of the new antiepileptic drugs.
Keywords: Anticonvulsant, antiepileptic, chronic subdural hematoma, epilepsy, head trauma, prophylaxis, seizure.
Current Pharmaceutical Design
Title:Antiepileptic Drugs for Preventing Seizures in Patients with Chronic Subdural Hematoma
Volume: 23 Issue: 42
Author(s): Pedro Moura Branco*, Bernardo Oliveira Ratilal, Joao Costa and Cristina Sampaio
Affiliation:
- Department of Neurosurgery, Centro Hospitalar de Lisboa Central, Lisbon,Portugal
Keywords: Anticonvulsant, antiepileptic, chronic subdural hematoma, epilepsy, head trauma, prophylaxis, seizure.
Abstract: Chronic subdural hematoma (CSH) is an accumulation of blood within the intracranial subdural space. It is associated with minor traumatic events and affects mostly the elderly. CSH can be effectively treated surgically with good outcomes, although the recurrence rate is high. Epileptic seizures are one of the major complications associated with CSH, either in the pre or postoperative period. The incidence rate of new onset seizures after CSH diagnosis ranges between 3% and 23%. However, the benefit of using prophylactic antiepileptic drugs in these patients is controversial with significant variations in clinical practice. It ranges from routine to total absence of use in this clinical context. The best current evidence does not allow any firm conclusion on whether such prophylactic treatment is effective, that is if it prevents the development of epileptic seizures. Furthermore, these drugs are associated with important adverse events. A systematic literature review found no controlled randomized trials evaluating the risk/benefit of the prophylactic use of anticonvulsants for people with CSH and retrospective studies showing contradictory results. Moreover, these observational studies are outdated and do not evaluate new generation drugs. Herein, we discuss the evidence for the use of antiepileptic drugs for preventing seizures in patients with CSH, with a particular focus on the subgroup of people most likely to benefit (such as the elderly and alcohol abusers), as well as the possible safety advantages of the new antiepileptic drugs.
Export Options
About this article
Cite this article as:
Branco Moura Pedro *, Ratilal Oliveira Bernardo , Costa Joao and Sampaio Cristina, Antiepileptic Drugs for Preventing Seizures in Patients with Chronic Subdural Hematoma, Current Pharmaceutical Design 2017; 23 (42) . https://dx.doi.org/10.2174/1381612823666171024144318
DOI https://dx.doi.org/10.2174/1381612823666171024144318 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
White Matter Damage Along the Uncinate Fasciculus Contributes to Cognitive Decline in AD and DLB
Current Alzheimer Research Functional Neuroimaging of Sleep Disorders
Current Pharmaceutical Design Meet Our Editorial Board Member
CNS & Neurological Disorders - Drug Targets UGT1A1 Mediated Drug Interactions and its Clinical Relevance
Current Drug Metabolism Dissecting the Mechanisms of Thrombogenesis and Atherosclerosis for Neurodegenerative Disorders
Current Neurovascular Research Research Review: Childhood Maltreatment and Executive Functioning During Adolescence
Adolescent Psychiatry A Convenient, Solvent Free and High Yielding Synthesis of Bicyclo- Heterocyclic Compounds
Letters in Organic Chemistry ABC Transporters and Drug Resistance in Patients with Epilepsy
Current Pharmaceutical Design Sugar Sulfamates for Seizure Control: Discovery and Development of Topiramate, a Structurally Unique Antiepileptic Drug
Current Topics in Medicinal Chemistry Structure-Activity Relationships of Selective GABA Uptake Inhibitors
Current Topics in Medicinal Chemistry Editorial [Hot Topic: Organ Involvement in the Antiphospholipid Syndrome (Guest Editors: Gerard Espinosa and Ricard Cervera)]
Current Rheumatology Reviews Synthesis and Anticonvulsant activity of Fluorinated Cyclic Enaminones
Letters in Drug Design & Discovery Editorial (Thematic Issue: In vivo MRS: Techniques and Applications)
Current Molecular Imaging (Discontinued) Canine Nutritional Model: Influence of Age, Diet, and Genetics on Health and Well-Being
Current Nutrition & Food Science Autoimmune Channelopathies of the Nervous System
Current Neuropharmacology Modulation of Potassium Channels as a Therapeutic Approach
Current Pharmaceutical Design Positron Emission Tomography: Applications In Drug Discovery and Drug Development
Current Topics in Medicinal Chemistry New Adamantane Derivatives with Sigma Affinity and Antiproliferative Activity
Medicinal Chemistry Natural Polymeric Nanoparticles for Brain-Targeting: Implications on Drug and Gene Delivery
Current Pharmaceutical Design An Overview of the Selectivity and Efficiency of the Bacterial Carbonic Anhydrase Inhibitors
Current Medicinal Chemistry