Anticonvulsants

The general principle is that any acute irritation of the cortical surface, including acute neurologic events such as head injury and SAH, has the potential to result in seizures.^{[63] [64]} Cortical incisions and irritation of the brain surface by retractors may similarly be potential foci. Given the relatively benign nature of diphenylhydantoin, provided that it is given judiciously, routine administration to patients undergoing most supratentorial craniotomies, as well as those who have sustained a significant head injury or SAH, seems appropriate in the absence of a contraindication. It is generally said that diphenylhydantoin should be administered at rates not greater than 50 mg/min. However, there is no necessity for rapid administration in a situation in which the intention is to prevent postoperative seizures, and it should be administered at a significantly slower rate.