Clin Neurol Neurosurg. 2026 May 10;268:109471. doi: 10.1016/j.clineuro.2026.109471. Online ahead of print.
ABSTRACT
SIGNIFICANCE: Levetiracetam (LTM), a second generation anti-epileptic drug, is routinely prescribed to patients for seizure prophylaxis following traumatic brain injury (TBI). Limited research exists on the safety and efficacy of levetiracetam in patients aged 80 + . This study investigates the association between levetiracetam administration and outcomes in patients 80 + with severe TBI.
METHODS: Our institutional trauma registry was queried for patients aged 80 + who did not have an active anti-epileptic drug prescription and were admitted for severe TBI between January 2021 – May 2023. Statistical tests were performed to determine any significant difference in demographics or outcomes between those who received LTM and those who did not.
RESULTS: 91 patients were included in the final analysis, 32 not given LTM and 59 given LTM. Age was significantly higher in the no-levetiracetam group (87.07 vs. 85.91; p = 0.04). ISS (25 vs. 17 p = 0.04), Max AIS Head (5 vs. 4; p < 0.01), and three-month mortality rates (28.8% vs. 9.4%; p = 0.03) were significantly higher in the levetiracetam group. Three levetiracetam patients (5.08%) had their prescriptions discontinued due to adverse effects. Three levetiracetam patients experienced seizures within seven days of TBI but did not experience seizures at 3 months follow-up.
CONCLUSION: Levetiracetam is well-tolerated for seizure prophylaxis in patients 80 + following TBI based on low rates of adverse effects. Levetiracetam is generally prescribed to patients with more severe TBIs. Further studies are needed to determine long-term outcomes of levetiracetam in octogenarians with TBI.
PMID:42143536 | DOI:10.1016/j.clineuro.2026.109471
