title: Effects of Prophylactic Antiepileptic Drugs on Clinical Outcomes in Patients with a Good Clinical Grade Suffering from Aneurysmal Subarachnoid Hemorrhage.
abstract: OBJECTIVE
  Routine use of prophylactic antiepileptic drugs (AED) has been debated. We retrospectively evaluated the effects of prophylactic AED on clinical outcomes in patients with a good clinical grade suffering from aneurysmal subarachnoid hemorrhage (aSAH).
  
  
  METHODS
  Between September 2012 and December 2014, 84 patients who met the following criteria were included: (1) presence of a ruptured aneurysm; (2) Hunt-Hess grade 1, 2, or 3; and (3) without seizure presentation. Patients were divided into two groups; the AED group (n = 44) and the no AED group (n = 40). Clinical data and outcomes were compared between the two groups.
  
  
  RESULTS
  Prophylactic AEDs were used more frequently in patients who underwent microsurgery (84.1%) compared to those who underwent endovascular surgery (15.9%, p < 0.001). Regardless of prophylactic AED use, seizure episodes were not observed during the six-month follow-up period. No statistical difference in clinical outcomes at discharge (p = 0.607) and after six months of follow-up (p = 0.178) were between the two groups. After six months, however, favorable outcomes in the no AED group tended to increase and poor outcomes tended to decrease.
  
  
  CONCLUSIONS
  No difference in the clinical outcomes and systemic complications at discharge and after six months of follow-up was observed between the two groups. However, favorable outcomes in the no AED group showed a slight increase after six months. These findings suggest that discontinuation of the current practice of using prophylactic AED might be recommended in patients with a good clinical grade.
authors.affiliation: Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Seon Jin
authors.initials: SJ
authors.lastname: Yoon
authors.affiliation: Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jin-Yang
authors.initials: JY
authors.lastname: Joo
authors.affiliation: Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. ; Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Yong Bae
authors.initials: YB
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. ; Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Chang-Ki
authors.initials: CK
authors.lastname: Hong
authors.affiliation: Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. ; Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Joonho
authors.initials: J
authors.lastname: Chung
keywords: Antiepileptic drug; Clinical outcome; Intracranial aneurysm; Seizure; Subarachnoid hemorrhage