North J B, Penhall R K, Hanieh A, Frewin D B, Taylor W B
J Neurosurg. 1983 May;58(5):672-7. doi: 10.3171/jns.1983.58.5.0672.
A double-blind trial of phenytoin therapy following craniotomy was performed to test the hypothesis that phenytoin is effective in reducing postoperative epilepsy. A significant reduction in the frequency of epilepsy was observed in the group receiving the active drug up to the 10th postoperative week. Half of the seizures occurred in the first 2 weeks and two-thirds within 1 month of cranial surgery. High rates of epilepsy were observed after surgery in patients with meningioma, metastasis, aneurysm, and head injury. Routine prophylaxis with phenytoin (in a dosage of 5 to 6 mg/kg/day) would seem to be indicated, particularly in high-risk patients and, where possible, this treatment should be started 1 week preoperatively. Seizure control is best when therapeutic levels of phenytoin are maintained.
进行了一项开颅术后苯妥英治疗的双盲试验，以检验苯妥英在降低术后癫痫发作方面有效的假设。在接受活性药物治疗的组中，直至术后第10周观察到癫痫发作频率显著降低。一半的癫痫发作发生在术后前2周，三分之二发生在颅脑手术后1个月内。在患有脑膜瘤、转移瘤、动脉瘤和头部损伤的患者中，术后观察到癫痫发作率较高。似乎有必要常规预防性使用苯妥英（剂量为5至6毫克/千克/天），特别是在高危患者中，并且在可能的情况下，这种治疗应在术前1周开始。当维持苯妥英的治疗水平时，癫痫控制效果最佳。
