Sodium valproate for prevention of early posttraumatic seizures.
OBJECTIVE
To assess the preventive effect of sodium valproate on early posttraumatic seizures in traumatic brain injury (TBI) patients.


METHODS
The retrospective study was based on 159 patients with TBI treated at Department of Neurosurgery, Nanjing General Hospital of Nanjing Command enrolled between January 1, 2008 and December 31, 2009. The in-hospital section of the retrospectively collected database includes information on age, sex, initial Glasgow Coma Score (GCS), results of CT scanning, operation, usage of sodium valproate, seizures in the first week after injury and outcome.


RESULTS
Seven patients (4.4%) showed early posttraumatic seizures. Although the incidence was zero in patients who received sodium valproate treatment, the difference between the treatment and control groups was not statistically significant. Of the 87 severe TBI patients (GCS 3-8), 6 patients in the control group (6.9%) suffered from early seizures during the first week after TBI and no patient who received preventive therapy suffered from seizures. The difference between the treatment and the control groups was still not statistically significant. Of the 72 mild and moderate TBI patients (GCS 9-15), only 1 patient in the control group suffered from seizures and no patient in the treatment group suffered.


CONCLUSIONS
Although the results suggest that the study is not sufficiently powerful to detect a clinically important difference in the seizure rates between the treatment and control groups, sodium valproate is effective in decreasing the risk of early posttraumatic seizures in severe TBI patients. Further prospective studies are recommended.
Ma
Chi-yuan
CY
Department of Neurosurgery, Nanjing General Hospital of Nanjing Command, Nanjing 210002, China. machiyuan@msn.com
Xue
Ya-jun
YJ
Li
Ming
M
Zhang
Yang
Y
Li
Guang-zhao
GZ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use*; D001930:Brain Injuries / Q000150:complications*; D004834:Epilepsy, Post-Traumatic / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014635:Valproic Acid / Q000627:therapeutic use*
D000927:Anticonvulsants; D014635:Valproic Acid