Preventing seizure occurrence following spontaneous intracerebral haemorrhage: A systematic review and meta-analysis of seizure prophylaxis

IntroductionSpontaneous intracerebral haemorrhage (ICH) is associated with high mortality and morbidity, including seizures. Seizure prophylaxis “not recommended” by the American Stroke Association, but practice variation still exists due to inconclusive data. We performed a meta-analysis assess current relevant literature determine efficacy of seizure following ICH.MethodsWe searches PubMed, Scopus, Embase up September 15, 2020. included observational randomized controlled studies reporting occurrence in adults ICH. Outcomes were seizures, as defined authors, within 14 days ICH at longest point follow-up. used random-effects models estimate odds ratios (ORs) for outcomes. The PROSPERO registration was CRD42019140493.ResultsWe 8 (2852 patients) our analysis. mean (± standard deviation) age pooled patients 65 (±4) years; 39 % 5%) female. did not prevent seizures follow-up time (OR 0.708, 95 CI 0.438–1.143, p = 0.158, I2 34 %). This result confirmed subgroup analyses using categorical variables meta-regressions continuous variables. Additionally, preventing early < 0.66, 0.21–2.08, 0.48, 35 %).ConclusionSeizure prevention adults. Most observational. Further trials examining high-risk different types antiepileptic drugs are needed.