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May 7, 1982

Prevention of Seizures After Cranial Trauma

JAMA. 1982;247(17):2372. doi:10.1001/jama.1982.03320420028022

To the Editor.—  It has been shown that prevention of seizures after head injuries can be accomplished by prophylactic anticonvulsant treatment.1 It is also common practice by some neurosurgeons to administer anticonvulsant drugs to patients after surgery for brain tumors, aneurysms, or other major intracranial pathological conditions. While this is a useful practice, the results are frequently vitiated by premature decrease or total withdrawal of the anticonvulsant agent. Under these circumstances one is likely to encounter withdrawal seizures, thereby producing what one had intended to avoid. Several such patients were seen by this author during the past year, and this is probably a relatively common occurrence around the country. It is known that 80% of all patients who experience posttraumatic seizures will do so within the first two years after the insult.2,3 After five years, the yearly incidence rate does not exceed that of the general population.4