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A double-blind trial of phenytoin therapy following craniotomy was performed to test the hypothesis that phenytoin is effective in reducing postoperative epilepsy. A significant reduction in the frequency of epilepsy was observed in the group receiving the active drug up to the 10th postoperative week. Half of the seizures occurred in the first 2 weeks and two-thirds within 1 month of cranial surgery. High rates of epilepsy were observed after surgery in patients with meningioma, metastasis, aneurysm, and head injury. Routine prophylaxis with phenytoin (in a dosage of 5 to 6 mg/kg/day) would seem to be indicated, particularly in high-risk patients and, where possible, this treatment should be started 1 week preoperatively. Seizure control is best when therapeutic levels of phenytoin are maintained.
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J. B. North
R. K. Penhall
Ahmad Hanieh
Journal of neurosurgery
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North et al. (Sun,) studied this question.
www.synapsesocial.com/papers/69dd5f81ae7c4d5b29100e1d — DOI: https://doi.org/10.3171/jns.1983.58.5.0672
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