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Question 3 Should carbamazepine be administered to manage agitation and aggressive behaviour following paediatric acquired brain injury?
  1. Emma Waters1,
  2. Matthew C H J Morrall1,
  3. Deborah Murdoch-Eaton2
  1. 1Paediatric Neuropsychology, The Leeds Teaching Hospitals NHS Trust, Leeds, UK
  2. 2Paediatric Neurology, The Leeds Teaching Hospitals NHS Trust and University of Leeds, Leeds, UK
  1. Correspondence to Matthew C H J Morrall, Paediatric Neuropsychology, The Leeds Teaching Hospitals NHS Trust, Leeds, UK; matthew.morrall{at}leedsth.nhs.uk

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Scenario

A 14-year-old boy sustains a brain injury and is admitted with a Glasgow Coma Scale score of 3/15. Imaging reveals evidence of diffuse injury. Approximately 12 months later, the patient is seen for a planned review in an outpatient clinic. Full reintegration into school has occurred and clear cognitive and physical improvements are evident. Despite this, the patient and his family explain that unprovoked episodes of agitation, aggression and emotional lability occur. These have not lessened in frequency and represent a clear departure from the patient's preinjury behaviour. Parental and school management of this concerning conduct is structured and consistent. You have heard that carbamazepine (CBZ) may be of value in managing post-injury agitation and aggression.

Structured clinical question

For children with an acquired brain injury [patient] does the administration of carbamazepine [intervention] reduce agitation and aggressive behaviour [outcome]?

Search strategy and outcome

Primary sources

An advanced search of AMED, CINAHL, EMBASE, MEDLINE, psychINFO and Google Scholar was completed. All databases were searched from 1980 to the present (February 2010) except AMED, which was searched from 1985 to the present.

Secondary sources

Cochrane Library (including Cochrane Reviews, Database of Abstracts of Review of Effects (DARE) and Clinical Trials and BestBETS) were searched using the terms ‘brain injury’ and ‘aggress*’ and ‘paediat*’ or ‘child*’ in the ‘Search All Text’ fields: no relevant results were found.

Search terms

Search terms included: ((traumatic adj2 …

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