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Neurocritical Care
Published in: Neurocritical Care 1/2011

01-08-2011 | Original Article

Levetiracetam is Associated with Improved Cognitive Outcome for Patients with Intracranial Hemorrhage

Authors: Scott Taylor, Robin J. Heinrichs, Jeff M. Janzen, As’ad Ehtisham

Published in: Neurocritical Care | Issue 1/2011

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Abstract

Background

To date, common therapy in patients with intracranial hemorrhage (ICH) includes prophylaxis of seizure using antiepileptic drugs, commonly phenytoin. Phenytoin therapy is associated with a high incidence of cognitive disturbance. Levetiracetam is known to cause less cognitive disruption and may be a suitable alternative for seizure prophylaxis. Cognitive outcomes in ICH patients receiving seizure prophylaxis with levetiracetam or phenytoin are compared.

Method

A retrospective chart review was conducted with 269 patients who received prophylactic levetiracetam or phenytoin between August 2005 and May 2008. A total of 85 reviewed patients met inclusion criteria (phenytoin n = 25, levetiracetam n = 60).

Results

Statistically significant results included higher Glasgow Coma Scores (GCS) at dismissal (median, 14 vs. 11, P = 0.023), lower seizure incidence (0.0 vs. 8%, P = 0.03) for patients receiving levetiracetam than those treated with phenytoin and patients being discharged home (21.7% vs. 16%, P = 0.03). Observed trends included greater cognitive function retention rate (56.7% vs. 36%, P = 0.08).

Conclusion

Despite similarities in hemorrhage type and severity at onset, patients receiving levetiracetam had better cognition at discharge and fewer seizures than patients receiving phenytoin. These data suggest that levetiracetam is more effective than phenytoin for seizure prophylaxis without suppression of cognitive abilities in patients with ICH.
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Metadata
Title
Levetiracetam is Associated with Improved Cognitive Outcome for Patients with Intracranial Hemorrhage
Authors
Scott Taylor
Robin J. Heinrichs
Jeff M. Janzen
As’ad Ehtisham
Publication date
01-08-2011
Publisher
Humana Press Inc
Published in
Neurocritical Care / Issue 1/2011
Print ISSN: 1541-6933
Electronic ISSN: 1556-0961
DOI
https://doi.org/10.1007/s12028-010-9341-6

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