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Efficacy Of Phenytoin In Prevention Of Early Posttraumatic Seizures

Nasim Gul1, Shahbaz Ali Khan1, Haider Ali Khattak1

  • 1Department of Neurosurgery, Ayub Medical College, Abbottabad, Pakistan.

Journal of Ayub Medical College, Abbottabad : JAMC
|May 17, 2019
PubMed

Insights

Prompt initiation of phenytoin within 12 hours can significantly reduce early post-traumatic seizures in moderate to severe traumatic brain injury patients. This timing is crucial for effective seizure prophylaxis.

Area of Science:

  • Neurosurgery
  • Neurology
  • Trauma Care

Background:

  • Early post-traumatic seizures are a significant concern following traumatic brain injury (TBI).
  • Anti-epileptic drugs show promise for seizure prophylaxis in TBI patients.
  • Phenytoin is a commonly used anti-epileptic for this purpose.

Purpose of the Study:

  • To evaluate the effectiveness of phenytoin in preventing early post-traumatic seizures in moderate to severe TBI.
  • To compare seizure frequency based on the timing of phenytoin initiation (within vs. after 12 hours post-injury).

Main Methods:

  • A cross-sectional study involving 163 patients with moderate to severe head injuries.
  • Patients were treated with phenytoin and monitored for early post-traumatic seizures.
  • Data collected on seizure occurrence relative to phenytoin administration timing.

Main Results:

  • 16% of patients experienced early post-traumatic seizures.
  • Seizure incidence was 9.89% when phenytoin was initiated within 12 hours.
  • Seizure incidence was 23.11% when phenytoin was initiated after 12 hours (p=0.018).

Conclusions:

  • Early post-traumatic seizures are frequent in moderate to severe TBI.
  • Initiating phenytoin within 12 hours of injury significantly reduces seizure risk.
  • Timely administration of phenytoin is recommended for seizure prophylaxis in TBI.
Abstract

Keywords:
Phenytoin; Seizures; Early post-traumatic seizuresProphylaxis; Brain injury; Head injury

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