What is the primary purpose of seizure prophylaxis in severe TBI?

• A. To reduce risk of post-traumatic seizures
• B. To reduce risk of infection
• C. To treat intracranial hypertension
• D. To improve wound healing

Answer: (A)

Seizure prophylaxis in severe traumatic brain injury is given to prevent early post-traumatic seizures. These seizures are most likely to occur in the first week after injury and can worsen brain damage by increasing metabolic demand, rising intracranial pressure, and causing secondary injury. By starting antiseizure medication, clinicians aim to reduce the incidence of these early seizures and thereby limit secondary brain injury during this vulnerable period, which can improve overall outcomes. It’s not primarily about preventing infections, treating intracranial hypertension, or speeding wound healing, which are managed by other interventions. The focus of prophylaxis is on lowering the risk of early seizures, with most guidelines recommending a limited duration (often around seven days) unless longer-term seizure risk is present.