Medical Journal of the Islamic Republic Of Iran

en Comparison of Efficacy and Safety of Levetiracetam Versus Phenytoin for Post-craniotomy Seizure Prophylaxis Neurosurgery Neurosurgery Original Research Original Research Background: Superiority of levetiracetam over phenytoin for postcraniotomy seizure prophylaxis in patients with a supratentorial brain tumor is controversial. We aimed to evaluate the efficacy of levetiracetam versus phenytoin for postcraniotomy seizure prophylaxis in supratentorial brain tumor.    Methods: In a randomized controlled trial study, 80 patients with a supratentorial brain tumor who underwent craniotomy were allocated to levetiracetam or phenytoin group, 40 patients each. Seizure prophylaxis was started 5 days before the surgery and continued until 90 days after surgery. Phenytoin group received 100 mg oral phenytoin 3 times a day. The levetiracetam group received 500 mg oral levetiracetam 2 times a day. The primary outcome was the incidence of postcraniotomy seizures. The secondary outcome measure was the safety profile of the drugs.    Results: All patients of the phenytoin group and 39 patients of levetiracetam completed the study. &lrm;Two seizures developed in the study population, &lrm;1 &rlm;in the &rlm;phenytoin group (2.5%) and 1 in the levetiracetam group (2.6%) (P = 0.710). Renal or hepatic dysfunction was not observed in any patients. Wound hematoma was seen in 5 patients (12.5%) of the phenytoin and 6 patients (15.4%) of the levetiracetam group (P = 0.481). Skin rash developed in 3 patients (7.5%) of the phenytoin group and no patient of the levetiracetam group (P = 0.132). Thrombocytopenia was detected in 1 patient of the phenytoin group (2.5%) and no patient of the levetiracetam group (P = 0.511). None of the adverse events led to drug withdrawal.    Conclusion: These results reveal no superiority of levetiracetam over phenytoin for postcraniotomy seizure prophylaxis in supratentorial brain tumor. Levetiracetam, Phenytoin, Craniotomy, Seizure, Prophylaxis, Supratentorial Brain Tumor 49 53 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-7290-3&slc_lang=en&sid=1 Morteza Faghihjouibari mortezafaghihj@yahoo.com 200319475328460076155 200319475328460076155 No Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Masoud Khadivi dr.m.khadivi@gmail.com 200319475328460076156 200319475328460076156 No Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Reza Rouhani rezamrohani@gmail.com 200319475328460076157 200319475328460076157 No Department of Neurosurgery, Amiralmomenin Hospital, Zabol University of Medical Sciences, Zabol, Iran Hamidreza Pazoki Toroudi Pazoki49@gmail.com 200319475328460076158 200319475328460076158 No Physiology Research Center and Department of Physiology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran Masoud Nazari dr.masoud.nazarii@gmail.com 200319475328460076159 200319475328460076159 No Bone and Joint Reconstruction Research Center, Department of Orthopedics, Schoolof Medicine, Iran University of Medical Sciences, Tehran, Iran Mahgol Sadeghian Mahgol.sadeghian73@gmail.com 200319475328460076160 200319475328460076160 No Pediateric Research Center, Department of pediateric, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Mehdi Abolfazli mehdiabolfazli1366@gmail.com 200319475328460076161 200319475328460076161 Yes Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran