A survey of attitudes toward the pharmacological prophylaxis of posttraumatic epilepsy

Abstract

✓ This survey reports the current use of pharmacological prophylaxis for posttraumatic epilepsy by 1064 board-certified neurosurgeons. Sixty per cent use anticonvulsants preventively, but under a variety of conditions. The indications for therapy were usually either severe head trauma with penetration of the dura or profound evidence of cortical contusion. Few patients were treated for minimal blunt injuries. Thirty-four per cent of respondents were uncertain of the indications for prophylatic treatment. The drug regimens were based on individual experience in 90.7% of responses and were aimed principally at pretreatment of clinical phenomena rather than true prophylaxis of the epileptogenic process. Diphenylhydantoin, 300 mg/day, was the preventive treatment recommended by more than 50% of those reporting, but the duration of therapy varied widely.