» Articles » PMID: 39606308

Comparison of Effectiveness of Brivaracetam and Levetiracetam for Prophylaxis of Early Post-Traumatic Seizures: A Prospective Comparative Interventional Study

Overview
Specialty Neurology
Date 2024 Nov 28
PMID 39606308
Authors
Affiliations
Soon will be listed here.
Abstract

 Early posttraumatic seizures (EPTS) are a major complication after a head injury, defined as seizures developing within the first 7 days of trauma. Levetiracetam has become a popular drug for the prevention of posttraumatic seizures in institutions worldwide. However, it has been reportedly associated with adverse effects like behavioral changes and somnolence. This study aimed to compare the efficacy of a newer drug, brivaracetam, which is reported to have a better pharmacokinetic profile. These findings may be significant in providing a safer yet efficacious alternative to levetiracetam.  The aim of this study was to evaluate the efficacy of brivaracetam for prophylaxis of EPTS and to compare it with levetiracetam.  A prospective, single-blind, parallel-group (alternate allocation) controlled trial over 100 patients admitted with traumatic brain injury in the Department of Neurosurgery, Goa Medical College, Panaji, Goa, India. The data was analyzed using IBM SPSS Statistics 29.0.  Twenty patients developed EPTS in the study group: 8 from the group receiving brivaracetam and 12 from the group receiving levetiracetam. Although the brivaracetam group had a lower incidence of EPTS, the difference was not statistically significant. Eleven patients from the levetiracetam group developed side effects, while six patients from the brivaracetam group had side effects. There was no significant difference in the incidence of side effects.  Brivaracetam has efficacy equal to that of levetiracetam for prophylaxis of EPTS.

References
1.
Niespodziany I, Klitgaard H, Margineanu D . Levetiracetam inhibits the high-voltage-activated Ca(2+) current in pyramidal neurones of rat hippocampal slices. Neurosci Lett. 2001; 306(1-2):5-8. DOI: 10.1016/s0304-3940(01)01884-5. View

2.
Xu J, Shen J, Shao W, Tang L, Sun Y, Zhai X . The safety and efficacy of levetiracetam versus phenytoin for seizure prophylaxis after traumatic brain injury: A systematic review and meta-analysis. Brain Inj. 2016; 30(9):1054-61. DOI: 10.3109/02699052.2016.1170882. View

3.
Genton P, Van Vleymen B . Piracetam and levetiracetam: close structural similarities but different pharmacological and clinical profiles. Epileptic Disord. 2000; 2(2):99-105. View

4.
Ghajar J . Traumatic brain injury. Lancet. 2000; 356(9233):923-9. DOI: 10.1016/S0140-6736(00)02689-1. View

5.
Lamar C, Hurley R, Rowland J, Taber K . Post-traumatic epilepsy: review of risks, pathophysiology, and potential biomarkers. J Neuropsychiatry Clin Neurosci. 2014; 26(2):iv-113. DOI: 10.1176/appi.neuropsych.260201. View