Antiseizure medications do not reduce the risk of epilepsy in patients with brain abscess

1. In patients with a brain abscess, use of antiseizure medications (ASM) was not associated with a statistical difference in the risk of epilepsy at 90, 135 and 180 days after initiation of ASMs. 

Evidence Rating Level: 2 (Good)

Epilepsy is a common complication of brain abscesses, yet the literature surrounding the appropriate management of epilepsy in the setting of a brain abscess is limited. Indeed, there have been limited efforts to investigate the effectiveness of ASMs in preventing epilepsy in brain abscess survivors. This retrospective cohort study therefore sought to assess the efficacy of ASMs in reducing epilepsy risk in patients with brain abscesses. 572 adult patients (mean[SD] age, 61.5[16.6] years; 61.6% male) from the United States with a documented acute care visit for brain abscess without prior history of epilepsy were included in the study. These patients were separated into a treatment group defined by having initiation of ASM within 45 days after the index date (n = 478) and no ASMs (n = 94). The primary outcome of the study was a diagnosis of epilepsy or seizures at 15 or greater days after the index date. There was no statistical difference in the incidence of epilepsy at 15 days or greater following the index date, with the marginal risk difference (RD) at 90 days being –0.02% [95% CI, −4.9% to 4.8%], at 135 days being 1.9% [95% CI, −5.0% to 8.5%] and at 180 days being 3.5% [95% CI, –4.4% to 10.8%]. Overall, this study found that the use of ASMs was not associated with a reduced risk of epilepsy. 

Click to read the study in JAMA Network Open

Image: PD

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