TY - JOUR
T1 - Impact of antiepileptic drugs for seizure prophylaxis on short and long-term functional outcomes in patients with acute intracerebral hemorrhage
T2 - A meta-analysis and systematic review
AU - Spoelhof, Brian
AU - Sanchez-Bautista, Julian
AU - Zorrilla-Vaca, Andres
AU - Kaplan, Peter W.
AU - Farrokh, Salia
AU - Mirski, Marek
AU - Freund, Brin
AU - Rivera-Lara, Lucia
N1 - Publisher Copyright:
© 2019 British Epilepsy Association
PY - 2019/7
Y1 - 2019/7
N2 - Purpose: The purpose of this analysis is to assess the effect of antiepileptics (AEDs) on seizure prevention and short and long term functional outcomes in patients with acute intracerebral hemorrhage. Method: The meta-analysis was conducted using the PRISMA guidelines. A literature search was performed of the PubMed, the Cochrane Library, and EMBASE databases. Search terms included “Anticonvulsants”, “Intracerebral Hemorrhage”, and related subject headings. Articles were screened and included if they were full-text and in English. Articles that did not perform multivariate regression were not included. Overall effect size was evaluated with forest plots and publication bias was assessed with the Begg's and Egger's tests. Results: A total of 3912 articles were identified during the initial review. After screening, 54 articles remained for full review and 6 articles were included in the final analysis. No significant association between the use of AEDs after ICH and functional outcome (OR 1.53 [95%CI: 0.81–2.88] P = 0.18, I 2 = 81.7%). Only one study evaluated the effect AEDs had in preventing post-ICH seizures. Conclusions: The use of prophylactic AEDs was not associated with improved short and long outcomes after acute ICH. This analysis supports the 2015 AHA/ASA recommendation against prophylactic AEDs (class III; level of evidence b).
AB - Purpose: The purpose of this analysis is to assess the effect of antiepileptics (AEDs) on seizure prevention and short and long term functional outcomes in patients with acute intracerebral hemorrhage. Method: The meta-analysis was conducted using the PRISMA guidelines. A literature search was performed of the PubMed, the Cochrane Library, and EMBASE databases. Search terms included “Anticonvulsants”, “Intracerebral Hemorrhage”, and related subject headings. Articles were screened and included if they were full-text and in English. Articles that did not perform multivariate regression were not included. Overall effect size was evaluated with forest plots and publication bias was assessed with the Begg's and Egger's tests. Results: A total of 3912 articles were identified during the initial review. After screening, 54 articles remained for full review and 6 articles were included in the final analysis. No significant association between the use of AEDs after ICH and functional outcome (OR 1.53 [95%CI: 0.81–2.88] P = 0.18, I 2 = 81.7%). Only one study evaluated the effect AEDs had in preventing post-ICH seizures. Conclusions: The use of prophylactic AEDs was not associated with improved short and long outcomes after acute ICH. This analysis supports the 2015 AHA/ASA recommendation against prophylactic AEDs (class III; level of evidence b).
KW - Antiepileptic drugs
KW - Clinical trials systematic review/meta-analysis
KW - Intracerebral hemorrhage
KW - Seizure prophylaxis
UR - http://www.scopus.com/inward/record.url?scp=85064764359&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85064764359&partnerID=8YFLogxK
U2 - 10.1016/j.seizure.2019.04.017
DO - 10.1016/j.seizure.2019.04.017
M3 - Article
C2 - 31048270
AN - SCOPUS:85064764359
SN - 1059-1311
VL - 69
SP - 140
EP - 146
JO - Seizure
JF - Seizure
ER -