Generating Evidence on NonEpileptic, Stereotypical and Intermittent Symptoms (NESIS) in Chronic Subdural Hematomas (GENESIS)
Chronic Subdural Hematoma, Epilepsy; Seizure, Cortical Depression; Cortical Depolarization
About this trial
This is an interventional treatment trial for Chronic Subdural Hematoma focused on measuring Transient neurological symptoms, Levetiracetam; keppra, Lamotrigine; lamictal
Eligibility Criteria
Inclusion Criteria:
- Be aged ≥ 18 years
- Chronic subdural hematoma
- Transient neurological symptoms (Sensory, motor, cerebellar or speech symptoms, lasting 6 hours or less)
- Initial negative EEG
Exclusion Criteria:
- Contraindications to Levetiracetam
- Psychiatric history (major depression, psychosis, risk of suicide)
- History of hypersensitivity to LEV (anaphylaxis, angioedema, skin reaction)
- Contraindications to Topiramate
- History of hypersensitivity to TPM
- Glaucoma
- Past of nephrolithiasis
- Known epilepsy or past seizure before the current subdural hemorrhage
- Actual taking of an antiepileptic drug
- Intracranial pathology not caused by subdural hematoma (intra-parenchymal hemorrhage, neoplasia)
- Pregnancy or planning to
- Inability to carry out the necessary follow-ups for the study
- Refusal of the attending physician
Sites / Locations
- Centre Hospitalier Universitaire de SherbrookeRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Active Comparator
Experimental
Active Comparator
Experimental
NESIS - Levetiracetam
NESIS - Topiramate
Non NESIS - Levetiracetam
Non-NESIS - Topiramate
Participant with a score NESIS of 4 or more (increased risk of having cortical depression). Levetiracetam is an anti-epileptic drug known to be inefficient in other condition with cortical depression. It will be use as an active comparator.
Participant with a score NESIS of 4 or more (increased risk of having cortical depression). Topiramate is an anti-epileptic drug known to be efficient in other condition with cortical depression. The investigators want to test his efficacy in chronic subdural hematoma with probable cortical depression.
Participant with a score NESIS of 3 or less (increased risk of having epileptic discharges). Levetiracetam is an anti-epileptic drug known to be inefficient in other condition with cortical depression. It will be use as an active comparator. Levetiracetam should be as efficient as Topiramate in a group a participant with epileptic discharges.
Participant with a score NESIS of 3 or less (increased risk of having epileptic discharges). Topiramate is an anti-epileptic drug known to be efficient in other condition with cortical depression. The investigators want to test his efficacy in chronic subdural hematoma with probable cortical depression. Topiramate should be as efficient as Levetiracetam in a group a participant with epileptic discharges.