The efficacy of Levetiracetam compared to Phenytoin in prevention of post-traumatic seizures: A prospective cohort study from a low-middle-income country

Abstract

Objectives: To compare the efficacy of Levetiracetam (LEV) versus Phenytoin (PHY) in the prevention of post-traumatic seizures in a low-middle-income country.

Materials and Methods: A prospective cohort study was conducted from 25^th December 2021 to 24^th June 2022 at the Pakistan Institute of Medical Sciences, Islamabad, Pakistan. A total of 140 patients presented with traumatic brain injury, both male and female, aged between 15 to 60 years were included. Patients with a history of epilepsy, acromegaly or hypogonadism, history of brain tumour or abscess were excluded. LEV was given to group A patients as a 1000 mg intravenous (IV) loading dose, followed by a dose of 500-1000 mg (orally) twice daily. PHY was given to group B patients as an IV loading dose of 15-20 mg/kg, followed by an oral dose of 4-8 mg/kg divided into three doses per day. All the patients were followed and the efficacy of the drugs was noted.

Results: The mean age of patients in groups A and B was 43.69 ± 9.05 SD years and 43.07 ± 9.46 SD years, respectively. The majority of the patients i.e., 108 (77.1%) were between the ages of 41 to 60 years. Out of the total 140 patients, 87 (62.1%) were males and 53 (37.9%) were females with male to female ratio of 1.6:1. LEV had an efficacy of 63 (90%) and PHY had an efficacy of 46 (65.7%) in this study, both having a p-value of 0.0005.

Conclusion: According to the results of this study, LEV is superior to PHY at preventing post-traumatic seizures.