Antiseizure Medication in Seizure Networks at Early Acute Brain Injury

Inclusion Criteria:

• Currently ICU hospitalized.

• Suppression of consciousness related to a neurological injury by medical chartreview.

• Glasgow Coma Scale of less than 13 at enrollment by medical chart review.

• Diagnosis of Acute brain injury by TBI, hypoxic-ischemic insult, cardiac arrest, orstroke by medical chart review.

• 2 to 90 days from acute brain injury to enrollment time by medical chart review.

• Have a surface EEG performed after the current ICU admission

• Clinically stable to undergo MRI scan, This stability is defined by care teamconcept, which should be stated in the medical records.

Exclusion Criteria:

• Previous medical history of Epilepsy by medical chart review.

• Previous medical history of neurological sequels that lead to dependence on care forbasic daily activities, by Barthel index score less than 80.

• Known allergy/Hypersensitivity or medical contraindications (like porphyria orcardiac arrhythmias) to the treatment protocol options, leaving no potentialcombination of drugs for the intervention without concerns for adverse eventsrelated to known preexistent conditions.

• Considered with Brain death by the care team in the medical record, at any time.

• Speaking fluently or at their prior reported baseline mental status by medical chartreview before the intervention starts.

• Contraindications for MRI scan.

• Prisoner human subjects by medical chart review.

• Confirmed currently pregnant by medical history or by positive blood or urinepregnancy test done in the present hospital admission.

• Treating physician determines the patient is no candidate to receive 2 of the 5protocol-specified ASM.