Efficacy of 48 hours dose of phenytoin in prevention of early post-traumatic seizure.

Abstract

Background:

Antiseizure medications, such as phenytoin sodium, have been shown in some reports to reduce the incidence of early post-traumatic seizure. These medications, however, are not without side effects which may be dose related or duration related. The risks associated with short-term therapy are minimal and often dose related (and hence avoidable). This study intends to determine the efficacy of a short-course (48-hour dose) of phenytoin in prevention of early post-traumatic seizure.

Methods:

This was a prospective randomised double-blind clinical intervention study. Head injured patients presenting within the first 24 hours were randomly assigned to either 48-hour dose of phenytoin or control groups, and were observed for clinical seizure over a week. The difference in the incidences of early post-traumatic seizure between the two groups was determined by χ2 test. A p<0.05 was considered as statistically significant.

Results:

A total of 94 patients were included in the study, 47 each in the control group and the phenytoin group. There were 77 males and 17 female (M:F 4.5:1). Both groups had similar demographic and clinical profile. The incidence of seizure was 21.3% in the control but 2.1% in the treatment arm (p<0.01). All seizures occurred within 24 hours of trauma in the control, while the only episode of seizure in the treatment group occurred later.

Conclusion:

A short-course (48-hour dose) of phenytoin might be an effective prophylactic treatment to reduce the incidence of early post-traumatic seizure.

• Authors: Toyin Ayofe Oyemolade, Augustine A Adeolu, Oluwakemi A Badejo, James A Balogun, Matthew T Shokunbi, Adefolarin O Malomo, Amos O Adeleye
• Journal: BMJ neurology open (BMJ Neurol Open) Vol. 5 Issue 1 Pg. e000377 ( 2023) ISSN: 2632-6140 [Electronic] England
• PMID: 36644000 (Publication Type: Journal Article)
• Copyright: © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.