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Seizure Prophylaxis After Head Injury
Topic overview
Clinical protocol for seizure prophylaxis in pediatric head injury patients at CCHMC. Recommends levetiracetam (20 mg/kg IV/PO q12h) for 7 days post-injury in patients with severe TBI (GCS <8), moderate TBI with specific CT findings, or early/late seizure activity.
Key Takeaways
- Levetiracetam (Keppra) is preferred for seizure prophylaxis: 20 mg/kg IV/PO q12h for 7 days post-injury (max 1000 mg q12h).
- Indications include severe TBI (GCS <8), moderate TBI (GCS 9-12) with CT findings, or any early/late seizure activity.
- CT findings warranting prophylaxis: frontal/temporal contusions, subdural hemorrhage.
- Contraindicated in patients with history of aggression/behavioral problems due to risk of exacerbating agitation.
- Neurology consult required for any patient with early (1 hour-7 days) or late (>7 days) post-traumatic seizures.
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How to cite: GlobalCastMD. Seizure Prophylaxis After Head Injury. GlobalCastMD Medical Library. https://library.globalcastmd.com/guideline/1849
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