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Epilepsia
Apr, 2025;66 (4): 955-969.

Antiseizure medication use in acute symptomatic seizures: A narrative review.

Ruta Yardi, Rani Priyanka Vasireddy, Marian Galovic, Vineet Punia
Author Information
  1. Ruta Yardi: Department of Neurology, Geisinger Neuroscience Institute, Geisinger Health System, Danville, Pennsylvania, USA. ORCID
  2. Rani Priyanka Vasireddy: Kentucky Neuroscience Institute, University of Kentucky, Lexington, Kentucky, USA.
  3. Marian Galovic: Department of Neurology, Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland.
  4. Vineet Punia: Epilepsy Center, Cleveland Clinic, Cleveland, Ohio, USA. ORCID
PMID: 39841056 DOI: 10.1111/epi.18275

Abstract

Acute symptomatic seizures, occurring shortly after a central nervous system insult, constitute nearly half of all seizure cases. However, there is a conspicuous absence of clear, comprehensive, and cohesive guidelines for the management of these seizures with antiseizure medications, especially their duration of use. This lack of consensus on the optimal duration of therapy leads to prolonged treatments that may carry adverse consequences. The primary objective of this narrative review is to present the existing evidence-based literature on the management of acute symptomatic seizures within the context of the underlying pathologies that trigger them. We explore the risk of developing epilepsy for each specific etiology and identify the factors that influence this risk. Finally, to facilitate decision-making regarding treatment duration, we categorize acute seizures based on the temporal characteristics of hyperexcitability as acute, subacute, and prolonged. Such a rubric may offer clarity in an area where consensus and guidelines are lacking.

Keywords

acute symptomatic seizures antiseizure medications autoimmune seizures epilepsy stroke traumatic brain injury

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MeSH Term

Humans
Anticonvulsants
Seizures
Acute Disease

Chemicals

Anticonvulsants
Journal Article Review

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