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Should antiepileptic drugs be used after head trauma to prevent the development of epilepsy
Seizure prophylaxis after moderate or severe TBI is often standard practice, but there is no definitive answer to this question.
The most recent study assessing posttraumatic prophylactic treatment with phenytoin concluded that therapy was useful only during the first week after head trauma.
At later dates, the side effects produced by phenytoin appeared to be detrimental to patients with severe neurologic damage after head trauma.
Valproate also has been found to be ineffective as a prophylactic agent after head trauma.
At present, no drug clearly has been shown to be an effective prophylaxis against posttraumatic epilepsy.
Sources
Temkin NR: Preventing and treating post-traumatic seizures. Epilepsia 50(Suppl 2):10-30, 2009.
Chang BS, Lowenstein DH, Quality Standards Subcommittee of the American Academy of Neurology: Practice parameter: antiepileptic drug prophylaxis in severe traumatic brain injury. Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 60:10-16, 2003.