Traumatic brain injury (TBI) is an important condition with high rates of disability and mortality worldwide. Post-traumatic seizure (PTS) frequently occur following TBI, manifesting in both early and late stages. Recurrent PTS without timely intervention may progress to post-traumatic epilepsy (PTE), which defined as the occurrence of two or more unprovoked seizures. Early pharmacological intervention is essential to mitigate the risk of PTE and enhance the prognosis for patients with TBI. Antiepileptic drugs (AEDs) offer a viable strategy for managing PTS. Recent studies indicated that AEDs are more effective in early post-traumatic seizure compared to late post-traumatic seizure, and their efficacy and safety require further evaluation. As research advances in the pathophysiological changes after TBI and the pathogenesis of PTS, current investigations are increasingly focused on neurological damage. Novel compounds targeting various pathways, including antioxidants, anti-neuroinflammatory agents, glutamate modulators and anti-oxidative stress compounds, have demonstrated promising potential in preclinical studies for PTS intervention. This review focuses on the research progress of different AEDs in PTS intervention and discusses the recent developments of emerging PTS intervention strategies based on multiple pathways, providing insights into the clinical application of AEDs and new directions for the development of new drugs for PTS intervention.
Keywords: antiepileptic drugs; pharmacological intervention; post-traumatic epilepsy; post-traumatic seizure; traumatic brain injury.
© The Author(s) 2025.