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Abstract Traumatic brain injury is defined as damage to the brain resulting from external mechanical force, such as rapid acceleration or deceleration, impact, or penetration by a projectile. Brain function is temporarily or permanently impaired and structural damage.(6) Brain injuries can be classified into mild, moderate, and severe categories. According to GCS, It is agreed that a TBI with a GCS of 13 or above is mild, 9–12 is moderate, and 8 or below is severe.(10,11) Post-traumatic seizures (PTS) are seizures that result from TBI. PTS may be a risk factor for post-traumatic epilepsy (PTE), PTS usually denote a more severe TBI. They may induce cerebral hypoxia which causes excess excitatory neurotransmitters to be released, increase the brain’s metabolic needs and increase the ICP contributing to further damage to the already injured brain. Thus, patients who suffer severe head trauma are given antiepileptic drugs as a precaution against seizures (82) A total of 150 patients with moderate or severe TBI were selected from Tanta University Emergency Hospital trauma patients. The studied patients were randomly and equally divided into 3 groups (n=50) according to the medication used to prevent PTS occurrence for 1 week after trauma: group 1 given PHT, group 2 given LEV and group 3 (control) where no medications given for prophylaxis. The aim of the study was to compare between PHT and LEV regarding role in PTS prophylaxis and their adverse effects. •The most common mode of trauma was RTA, followed by FFH, local head injury and then falling down. There were no significant differences between the 3 study groups regarding the modes of trauma. The GCS was used to define the level of consciousness and severity of TBI. There were no significant differences between the 3 groups in this concern. The GCS range was 3-12 in the 3 groups. The findings of CT-brain were approximated to each other in the study groups. In the overall, SDH was the most common finding followed by brain edema, EDH, brain contusion, fracture base, fissure fracture , SAH, IVH and then pneumocephalus. Antiepileptic medications were effective in PTS prophylaxis with PHT as potent as LEV in this regard. Immediate PTS were present in 22% of PHT, 28% of LEV and 26% of control group (table 10), while early PTS were present in 18% of PHT, 14% of LEV and 22% of control group.(table 9) To evaluate the effects of PHT and LEV on liver functions, liver enzymes were withdrawn on admission and on 7th day. Significant difference appeared on 7th day liver functions between PHT and control groups, while no differences evolved between LEV and control groups. |