Colin Pinder1, Carolyn Young. 1. The Walton Centre NHS Foundation Trust, Fazakerley, Liverpool, UK. colin.pinder@nhs.net
Abstract
BACKGROUND: The use of prophylactic anticonvulsants following brain injury is controversial. When used for this reason or for treatment of early seizures, anticonvulsants, particularly phenytoin, can cause severe cognitive side-effects. CASE REPORT: This study presents a case of a woman with a severe brain injury with severe cognitive impairment who improved dramatically following withdrawal of phenytoin. The literature regarding such cognitive side-effects is contradictory with no consistent indication of choice of anticonvulsants to use in this situation. CONCLUSION: As a result of the dramatic improvement in this case, one should now routinely withdraw or change phenytoin treatment in all brain injury patients with significant cognitive impairment.
BACKGROUND: The use of prophylactic anticonvulsants following brain injury is controversial. When used for this reason or for treatment of early seizures, anticonvulsants, particularly phenytoin, can cause severe cognitive side-effects. CASE REPORT: This study presents a case of a woman with a severe brain injury with severe cognitive impairment who improved dramatically following withdrawal of phenytoin. The literature regarding such cognitive side-effects is contradictory with no consistent indication of choice of anticonvulsants to use in this situation. CONCLUSION: As a result of the dramatic improvement in this case, one should now routinely withdraw or change phenytoin treatment in all brain injurypatients with significant cognitive impairment.
Authors: Bo Wang; Hana Dawson; Haichen Wang; Dawn Kernagis; Brad J Kolls; Lucy Yao; Daniel T Laskowitz Journal: Neurocrit Care Date: 2013-08 Impact factor: 3.210