Antiepileptic drugs for the primary and secondary prevention of seizures after intracranial venous thrombosis

Abstract

Background: Intracranial venous thrombosis (ICVT) commonly presents with seizures in the acute period, and some patients may develop recurrent seizures in the long term. The prophylactic use of antiepileptic drugs (AEDs) for the management of post-ICVT seizures is controversial and there is currently no consensus on the optimal management of post-ICVT seizures.

Objectives: To assess the effects of AEDs for the primary and secondary prevention of seizures related to ICVT.(1) Do AEDs reduce the likelihood of seizures in patients who have had an ICVT but have not had a seizure?(2) Do AEDs reduce the likelihood of further seizures in patients who have had an ICVT and at least one seizure?

Search strategy: We aimed to identify relevant studies in the Cochrane Epilepsy Group and Cochrane Stroke Group Trials Registers. We also undertook specialised searches of the Cochrane Central Register of Controlled Trials (CENTRAL) and MEDLINE, and checked the reference lists of articles retrieved from the searches.

Selection criteria: We considered all randomised and quasi-randomised controlled trials in which patients were assigned to a treatment group (that is, receiving at least one AED) or control group (receiving placebo or no drug).

Data collection and analysis: Both review authors independently screened and assessed the methodological quality of the studies. If studies had been included, then one review author would have extracted the data and the other would have checked the extracted data.

Main results: No relevant studies were found.

Authors' conclusions: There is no evidence to support or refute the use of antiepileptic drugs for the primary or secondary prevention of seizures related to intracranial venous thrombosis. Well-designed randomised controlled trials are urgently needed to inform practice.