A neurosurgeon addresses taking anti-seizure drugs after head trauma even if there are no symptoms, just in case to prevent a seizure.

Keppra is an anti-seizure drug that may be given to a patient who has been diagnosed with a chronic subdural hematoma following a head trauma, such as hitting the head in a fall.

But the drug is given when there are neurological symptoms, and not necessarily a seizure-type symptom.

After my mother underwent surgical draining of a chronic subdural hematoma, she was prescribed Keppra, because the risk of a seizure exists post-surgically for this condition.

Seizures are one of the more uncommon symptoms that arise from a chronic subdural hematoma prior to treatment.

More common symptoms are headaches, mental changes and weakness.

If you know that seizures (though not commonly) can result from a chronic subdural hematoma (that develops after head trauma), you then might wonder this:

Why not take an anti-seizure drug even if the CT scan is normal and the patient has no symptoms — just to play it safe?

After all, a normal CT scan doesn’t predict a future normal CT scan.

A chronic subdural hematoma may take up to 90 days to develop enough to start causing symptoms, which as mentioned, can include a seizure.

So why not be ready for a seizure by taking an anti-convulsant medication on a “just in case” basis?

Otherwise, the patient, unaware that a brain bleed is developing, might have a seizure from it while driving or walking down a flight of stairs.

To all of this, here is what Ivan Mikolaenko, MD, says:

“No prophylactic antiepileptic drugs are recommended in a patient with normal CT scan and no seizure following head injury!!!”

Dr. Mikolaenko is a board certified neurologist of 20+ years based in New York with subspecialty certification in neurocritical care.

dr. mikolaenko
Conditions treated by Dr. Mikolaenko in the intensive care setting include strokes, ruptured aneurysms, trauma-related brain and spinal cord injuries, seizures and brain swelling, infections and tumors.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  


Top image: Shutterstock/Masha Petrakova