COMMENT. The authors admit that the small and uncertain effect of antiepileptic drug treatment in this study might be related to non-compliance and failure to achieve optimal blood levels. Of those blood levels available a significant proportion of phenytoin levels were suboptimal, and it could be argued that the more rigorous monitoring might have improved results. In contrast, satisfactory carbamazepine levels were achieved and yet, there was no difference in outcome. These findings suggest that phenytoin has a greater prophylactic action than carbamazepine in postcraniotomy seizure control. According to Drs. Wingkun and Awad at the Cleveland Clinic, changes in antiepileptic drugs, dosages or poor compliance may be important factors in postoperative recurrence of seizures (see Ped Neurol Briefs Jan 1992; 6:8). The unusually high incidence of skin rashes associated with anticonvulsant treatment in this study suggests that postcraniotomy patients are more susceptible than non-surgical patients with epilepsy. The respective frequency of skin rash with the two anti-convulsants used in this study was not stated. It would be of interest to know if the antibiotic Cefotaxim was administered to these surgical patients in conjunction with the anticonvulsant, since this combination of drugs is known to increase the risk of serious skin reactions (see Ped Neurol Briefs May 1992; 5:37).