Levetiracetam to Prevent Post-Traumatic Epilepsy
Epilepsy, Post-traumatic Epilepsy
About this trial
This is an interventional prevention trial for Epilepsy focused on measuring Post-Traumatic epilepsy, Traumatic brain injury, Epilepsy prevention, Levetiracetam
Eligibility Criteria
Inclusion Criteria:
- Acute head injury associated with one of the following:
Intracranial hemorrhage, including epidural, subdural and intracerebral hemorrhage or with cerebral contusion(s) of any size; Penetrating (foreign body) head injury; Skull fracture and dural tear; Seizure within 8 hours of head injury
- Onset of head injury within 8-hours of proposed treatment initiation.
- Glasgow Coma Scale 6-15.
Exclusion Criteria:
Clinical contraindications:
- Previous epilepsy or status epilepticus.
- Any systemic illness or unstable medical condition that might pose additional risk, including: renal insufficiency, other unstable metabolic or endocrine disturbances, and active systemic cancer.
- Psychosis within six months of enrollment as determined by history of hospitalization for psychosis or medications for psychosis.
- Moderate to severe mental retardation (IQ< 55 or>2 school grade levels below the expected for age [expected age = grade level +5]).
Clinical/Laboratory Indicators:
- Serum creatinine > 1.5 on the day of treatment initiation for adults.
- Serum creatinine ≥1.5 for subjects ≥17 years old, ≥1.0 for subjects 13-17 years old and ≥0.7 for subjects 6-12 years old.
- Pregnancy
- Use of any CNS-active investigational drugs within 3 months of enrollment.
- Use of Antiepileptic Drugs (AEDs) within two months of enrollment, for any indication.
- Allergy/sensitivity to study drugs or their formulations:
- Active drug or alcohol dependence that, in the opinion of the site investigator, would interfere with adherence to study requirements:
- Inability or unwillingness of subject or legal guardian/representative to give written informed consent.
Sites / Locations
- Children's National Medical Center
- MedStar Research Institute
Arms of the Study
Arm 1
Arm 2
Active Comparator
No Intervention
Levetiracetam
No Intervention Control
66 subjects with acute head injury with a high risk for developing post-traumatic epilepsy will receive levetiracetam 55 mg/kg/day in a b.i.d. schedule. Treatment will commence within 8 hours of the acute head injury and will last for 30 days. In addition, subjects will receive phenytoin for 1 week following head injury as standard clinical care.
60 subjects with acute head injury with a high risk for developing post-traumatic epilepsy enrolled 8-24 hours after injury will not receive levetiracetam. Subjects will receive phenytoin for 1 week following head injury as standard clinical care.