Seizures are a well-recognized occurrence after aneurysmal subarachnoid hemorrhage (aSAH). However, incidence rates vary within the reported literature and controversy exists regarding the utility of prophylactic antiepileptic drug (AED) administration. In the May/June 2013 issue of World Neurosurgery, Raper and colleagues conducted a systematic review of seizure incidence following aSAH in 25 studies involving 7002 patients. They examined the impact of AED prophylaxis and treatment modality (endovascular versus open surgical) on seizure frequency. Among all patients with aSAH, the incidence of early and late postoperative seizures was 2.3% and 5.5%, respectively. The incidence of late seizures was lower in patients treated by endovascular coiling than those treated with surgical clipping (3.3% vs. 6.5%). The authors suggested that routine perioperative AED use does not seem to prevent post-operative seizures following aSAH.