Antiepileptic prophylaxis following severe XXXX within a military cohort.

@entity32933 @entity1 @entity131 @entity410
INTRODUCTION: @entity131 increases the risk of both early and late @entity410 . Antiepileptic prophylaxis reduces early @entity410 , but their use beyond 1   week does not prevent the development of @entity32933 . Furthermore, prolonged prophylaxis exposes @entity1 to side effects of the drugs and has occupational implications. The American Academy of Neurology recommends that antiepileptic prophylaxis should be started for @entity1 with severe @entity131 and discontinued after 1   week. An audit is presented here that investigates the use of prophylaxis in a cohort of military @entity1 admitted to the UK Defence Medical Rehabilitation Centre (DMRC). METHODS: Data were collected and analysed retrospectively from electronic and paper records between February 2009 and August 2012. The timing and duration of antiepileptic drug use and the incidence of @entity410 were recorded. RESULTS: During the study period, 52 @entity1 with severe @entity131 were admitted to the rehabilitation centre: 25 @entity1 (48%) were commenced on prophylaxis during the first week following injury while 27 (52%) did not receive prophylaxis. Only one @entity1 (2%) received prophylaxis for the recommended period of 1   week, 22 @entity1 (42%) received prophylaxis for longer than 1   week with a mean duration of 6.2   months. Two @entity1 (4%) had @entity32933 and started on treatment at DMRC. CONCLUSIONS: The use of antiepileptic prophylaxis varies widely and is generally inconsistent with evidence-based guidance. This exposes some @entity1 to a higher risk of early @entity410 and others to unnecessary use of antiepileptics. Better implementation of prophylaxis is required.
