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More harm than good: antiseizure prophylaxis after traumatic brain injury does not decrease seizure rates but may inhibit functional recovery.

J Trauma Acute Care Surg

January 2014

From the Division of Acute Care Surgery (I.S.B., J.P., A.K., E.F.), Division of Pharmacy (D.J.), and Division of Pediatrics (J.J.T.), University of Florida College of Medicine (D.J., J.P., E.F.), Jacksonville, Florida..

Background: The purposes of this study were to examine the current Brain Trauma Foundation recommendation for antiseizure prophylaxis with phenytoin during the first 7 days after traumatic brain injury (TBI) in preventing seizures and to determine if this medication affects functional recovery at discharge.

Methods: The records of adult (age ≥ 18 years) patients with blunt severe TBI who remained in the hospital at least 7 days after injury were retrospectively reviewed from January 2008 to January 2010. Clinical seizure rates during the first 7 days after injury and functional outcome at discharge were compared for the two groups based on antiseizure prophylaxis, no prophylaxis (NP) versus phenytoin prophylaxis (PP).

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