Levetiracetam found effective for acute seizure prevention in intracerebral hemorrhage: LANCET

A new investigation found that acute seizures in intracerebral hemorrhage can be prevented by Levetiracetam. The study was published in the journal 'The LANCET Neurology.' 

There is a 30% incidence of early seizures after intracerebral hemorrhage when subclinical seizures are diagnosed by EEG, and this can cause hematoma expansion and worsening neurological outcomes. Presently there are no guidelines on prophylactic antiseizure treatment. Hence researchers conducted a double-blind, randomized, placebo-controlled, phase 3 trial to assess if prophylactic levetiracetam would reduce the risk of acute seizures in patients with intracerebral hemorrhage. 

The phase 3 PEACH trial was conducted at three stroke units in France by including patients who were aged 18 years or older and presented with a non-traumatic intracerebral hemorrhage within 24 h after onset. The participants were randomly assigned with a web-based system and stratified by center and National Institutes of Health Stroke Scale (NIHSS) score at baseline, to intravenous levetiracetam 500 mg every 12 h or matching placebo. The treatment was carried out for 6 weeks and continuous EEG was started within 24 h after inclusion and recorded over 48 h. The primary endpoint was the occurrence of at least one clinical seizure within 72 h of inclusion or at least one electrographic seizure recorded on continuous EEG, analyzed in the modified intention-to-treat population, which comprised all patients who were randomly assigned to treatment and who had a continuous EEG performed.