Official Publication of the National Center for Trauma Research Trauma Monthly 2251-7464 31 4 2026 07 01 A Comparison of Seizure Prophylaxis in Brain Traumatic Injury: Sodium Valproate Versus Levetiracetam 1992 1997 253294 10.30491/tm.2026.588483.1949 EN Mehdi Mahmoodkhani Department of Neurosurgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Ali Zare Department of General Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Kimia Ghorbani Department of General Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Golnoosh Shahverdi Department of General Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Iman Salehi Department of Neurosurgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Ahmadreza Rafiei Department of Neurosurgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. 0000-0001-9760-6882 Journal Article 2026 06 24 <strong>Introduction: </strong>Literature is rife with discordant results regarding the use of antiepileptic drugs for prophylaxis of Post-traumatic epilepsy. This study was conducted in Isfahan hospitals to compare the effectiveness of Sodium Valproate and Levetiracetam in preventing early seizures in patients with traumatic brain injuries.<br><strong>Method: </strong>A total of 160 patients with traumatic brain injury treated in Kashani Hospital (Isfahan, Iran) from 2024 to 2025 were enrolled and divided into group A (n=80) and group B (n=80) according to random sampling. The medication was continued for 3 months after the injury.<br><strong>Result: </strong>There were no statistically significant differences in demographic and clinical information between the two groups (P>0.05). We failed to determine a significant relationship between the antiepileptic drug used and the initial EEG (P=0.584) and seizure activity (P= 0.680) between the two drug groups. However, a significant correlation between the antiepileptic drug used and seizure activity was found at subsequent follow-ups (10, 180 days); patients who took levetiracetam had a decreased incidence of seizure activity at follow-ups. There was no significant correlation between the GCS score, both initially and on two follow-ups, and the antiepileptic drug used.<br><strong>Conclusion<span dir="RTL" lang="FA">: </span></strong> Logically, it would seem that the long-lasting high risk of epilepsy after brain injury might be reduced if prophylactic antiepileptic drugs are administered. Looked specifically at prophylactic antiepileptic drugs post-TBI and reported a better safety profile, with a lower adverse drug reaction rate, for Levetiracetam versus Sodium Valproate. https://www.traumamon.com/article_253294_08cbc58f5af5e0efc15343dab01a540a.pdf