Journal of neurology, neurosurgery, and psychiatry
-
J. Neurol. Neurosurg. Psychiatr. · Jan 1998
Meta AnalysisProphylactic antiepileptic agents after head injury: a systematic review.
To determine the effectiveness and safety of prophylactic antiepileptic agents in the management of acute traumatic head injury. ⋯ Prophylactic antiepileptic drugs are effective in reducing early seizures, but there is no evidence that treatment with such drugs reduces the occurrence of late seizures, or has any effect on death and neurological disability. Insufficient evidence is available to establish the net benefit of prophylactic treatment at any time after injury.
-
J. Neurol. Neurosurg. Psychiatr. · Jan 1998
Comparative StudyMeasurement of impaired consciousness in the neurological intensive care unit: a new test.
Neurological deterioration in alert patients with an acute CNS disorder can be subtle, but current coma scales may not clearly capture changes in level of alertness. Many coma scales include components such as eye opening and content of speech, features that are difficult to assess in intubated patients and patients with facial trauma. Two new tools have been devised by the authors. ⋯ On the first visit 49% of all tests with a maximum Glasgow coma score had a negative continuous performance test as opposed to 13% of tests with a less than maximum Glasgow coma score. For the consecutive hand position test, these numbers were respectively 25% and 2%. These tests may be a reasonable alternative to the Glasgow coma score to monitor patients, in particular when the verbal and eye response cannot be reliably tested.