Keppra for TBI?

[hotshot12345]

My pt had a traumatic brain injury. He is on Propanol for his sympathetic storming. He is on Keppra b/c he is allergic to Dilantin. However, why would he need Keppra? He does not have a seizure disorder. He has hydrocephalus and I read that it can result in seizures. Is that the reason or is it also to prevent storming as well?

[GrnHonu99, RN]

My pt had a traumatic brain injury. He is on Propanol for his sympathetic storming. He is on Keppra b/c he is allergic to Dilantin. However, why would he need Keppra? He does not have a seizure disorder. He has hydrocephalus and I read that it can result in seizures. Is that the reason or is it also to prevent storming as well?

There are many reasons that people seize....too much pressure on the brain, really high fever, bleeding in the brain.....better to err on the side of caution and load em up with keppra/dph

[TiredMD]

My pt had a traumatic brain injury. He is on Propanol for his sympathetic storming. He is on Keppra b/c he is allergic to Dilantin. However, why would he need Keppra? He does not have a seizure disorder. He has hydrocephalus and I read that it can result in seizures. Is that the reason or is it also to prevent storming as well?

We see a lot of TBI. Patients are commonly loaded with Keppra for seizure prophylaxis, and taken off a couple months later if they haven't shown any seizure activity. Remember that TBI, even in the absence of hydrocephalus/bleeding/edema, is a common cause of seizures.

We now prefer Keppra to Dilantin, because it doesn't require monitoring of levels, and has an excellent safety profile.