title: Survey of prophylactic antiseizure drug use for non-traumatic intracerebral hemorrhage.
abstract: OBJECTIVE
  Prophylactic antiseizure drugs (PAD) are commonly prescribed for non-traumatic intracerebral hemorrhage (ICH) despite limited evidence for this indication. We sought to determine the current prescribing patterns of the use of a PAD for ICH.
  
  
  METHODS
  A 36-item survey was distributed to physicians who manage ICH patients soliciting details of PAD prescription in their practice.
  
  
  RESULTS
  A total of 199 physicians responded to the survey, all of who manage 50 or more ICH patients per year. The respondents were neurologists (32%), neurosurgeons (11%), and intensivists (57%) in academia (69%) and private practice (31%). Prophylactic antiseizure drugs prescriptions used: never (33%), 1-33% (35%), 34-66% (14%), 67-99% (9%) of the time, or always (9%). Most respondents performed electroencephalographic and serum level monitoring in at least some patients. Levetiracetam was used most often (60%), followed by fosphenytoin (37%), for a usual duration of days (36%), weeks (47%), or months (17%). Prophylactic antiseizure drugs prescription varied by patient characteristics and physician specialty. Perception of physician community consensus regarding PAD use for ICH among respondents ranged from strongly (7%) or weakly (23%) against the practice, to a fairly equal division of opinion (41%), to weakly (27%) or strongly (4%) in favor of the practice.
  
  
  CONCLUSIONS
  We found variability of multiple aspects of the current prescribing patterns and opinions regarding the use of a PAD for ICH. This variability is likely secondary to insufficient data. Clinical equipoise exists for this issue, and controlled trials would be both justified and useful.
authors.affiliation: University of Wisconsin, Madison, WI, USA.
authors.forename: Matthew B
authors.initials: MB
authors.lastname: Jensen
authors.forename: Ahsan
authors.initials: A
authors.lastname: Sattar
authors.forename: Khalid
authors.initials: K
authors.lastname: Al Sherbini
mesh_terms: D000927:Anticonvulsants / Q000008:administration & dosage / Q000627:therapeutic use*; D001921:Brain / Q000473:pathology; D002543:Cerebral Hemorrhage / Q000150:complications / Q000188:drug therapy*; D011307:Drug Prescriptions; D004363:Drug Utilization; D004569:Electroencephalography; D006801:Humans; D000077287:Levetiracetam; D010672:Phenytoin / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D010889:Piracetam / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D010818:Practice Patterns, Physicians' / Q000639:trends*; D012640:Seizures / Q000209:etiology / Q000517:prevention & control*; D011795:Surveys and Questionnaires
chemical_list: D000927:Anticonvulsants; D000077287:Levetiracetam; D010672:Phenytoin; C043114:fosphenytoin; D010889:Piracetam