Seizure Prophylaxis in Aneurysmal SAH: New Guidelines

Aug 5, 2026 · Published in: Neurocritical Care

Oncology

Background Information

Seizure prophylaxis in aneurysmal SAH: ASM or not?

Guidelines for seizure prophylaxis in aneurysmal subarachnoid hemorrhage (SAH) are limited, impacting clinical decisions. No significant outcome difference between antiseizure medication (ASM) and no ASM; phenytoin/fosphenytoin reduced early seizures, levetiracetam lowered neurologic decline risk. The study provides conditional recommendations with low-quality evidence, highlighting the need for individualized treatment decisions. Consider levetiracetam or phenytoin/fosphenytoin for seizure prophylaxis in aneurysmal SAH.

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Authors: Rowe AS, Zafar SF, Tesoro E, Gilmore EJ, Johnson EL, Olson D, Rayi A, Ullman J, Yuan Y, Frontera JA

Citation: Rowe AS, Zafar SF, Tesoro E, et al. Guidelines for Seizure Prophylaxis in Patients with Aneurysmal Subarachnoid Hemorrhage: A Statement for Healthcare Professionals from the Neurocritical Care Society. Neurocritical care. 2026. doi:10.1007/s12028-026-02614-z

Article Links: PubMed · Journal / DOI

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