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In a retrospective study of 93 adults who presented to a single trauma center after severe head injury, researchers compared seizure rates within 7 days after injury and functional outcomes at discharge between 50 patients who received antiseizure prophylaxis with phenytoin and 43 who received no prophylaxis. Severe head injury was defined as Glasgow Coma Scale score of 3–8 and evidence of traumatic head injury on head computed tomography (subarachnoid hemorrhage, intracerebral hemorrhage, subdural hematoma, epidural hematoma, or diffuse axonal injury).
Seizure rates were similar in the two groups. Functional outcomes were worse in the phenytoin-prophylaxis group than the no-prophylaxis group (mean Glasgow Outcome Scale score, 2.9 vs. 3.4; m…