Relation of prophylactic medication to the occurrence of early seizures following craniocerebral trauma

✓ In a series of 1614 cases of combat head injury incurred in Vietnam between 1967 and 1970, 70% received prophylatic anticonvulsant medication (diphenylhydantoin, 300 to 400 mg/day); 36 developed fits in the first week following injury. The prophylactic regimen had no recognizable effect. Therapeutic serum levels of anticonvulsants are not achieved for 2 or 3 weeks. Usefulness of dexamethasone in controlling brain swelling may be seriously impaired by diphenylhydantoin. Thus prophylaxis against early posttraumatic fits may not be practical or desirable.