ANTIEPILEPTIC MEDICATIONS AND SEIZURES
Seizures are common after severe brain trauma. Administer seizure prophylaxis to avoid the hemodynamic changes and increased cerebral metabolic activity caused by seizures. Seizure medications help prevent early post-traumatic seizures, but do not prevent all seizures. Up to 25% of patients with severe TBI will have seizures even with prophylactic treatment. Fifty percent of seizures may be non-convulsive in nature. Patients with subdural hematoma, neurosurgical procedure, or penetrating brain injury are at the highest risk of seizures. Post-traumatic seizures have been shown to increase morbidity and mortality after trauma.44-47
Lorazepam 1-2mg IV or Midazolam 5-10mg IV. Lorazepam is preferred. If no IV access, Midazolam IM is as effective as Lorazepam IV