Antiepileptic drugs for the primary and secondary prevention of seizures after subarachnoid haemorrhage

Abstract

BACKGROUND: Subarachnoid haemorrhage may result in seizures both acutely and in the longer term. The use of antiepileptic drugs (AEDs) in the primary and secondary prevention of seizures after subarachnoid haemorrhage is uncertain, and there is currently no consensus on treatment. OBJECTIVES: To assess the effects of AEDs for the primary and secondary prevention of seizures after subarachnoid haemorrhage. SEARCH METHODS: We searched the Cochrane Epilepsy Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (2013, Issue 1) in The Cochrane Library, and MEDLINE (1946 to 12th March 2013). We checked the reference lists of articles retrieved from these searches. SELECTION CRITERIA: We considered all randomised and quasi-randomised controlled trials in which patients were assigned to a treatment (one or more AEDs) or placebo. DATA COLLECTION AND ANALYSIS: Two review authors (RM and JK) independently screened and assessed the methodological quality of the studies. If studies were included, one author extracted the data and the other checked it. MAIN RESULTS: No relevant studies were found. AUTHORS' CONCLUSIONS: There was no evidence to support or refute the use of antiepileptic drugs for the primary or secondary prevention of seizures related to subarachnoid haemorrhage. Well-designed randomised controlled trials are urgently needed to guide clinical practice.