Dilantin (Phenytoin) has been used for decades to treat seizures in adults and children, primarily for epilepsy as well as during and after surgeries. The Epilepsy Foundation says that over three million Americans have some form of seizure disorder, with 200,000 new cases diagnosed every year.
Dilantin works by slowing down neural activity in the brain that would otherwise cause a seizure. It is typically prescribed to manage grand mal seizures (which includes a loss of conciousness and involuntary muscle contortions), as well as temporal lobe seizures (which can affect taste, sight, smell, hearing, memory, and movement).
Certain physical side effects to Dilantin, such as periodontal disease, tooth decay and a loss of bone density have been well documented. Cognitive side effects have also been noted, such as word-retrieval, short-term memory and concentration difficulties.
Dilantin may accumulate in the cerebral cortex over long periods of time. When given at very high doses, it can cause atrophy of the cerebellum.
In 2008, the FDA announced plans to investigate the intravenous use of Dilantin. The FDA is now advising doctors to avoid using Dilantin for patients who test positive for HLA-B*1502. This is a human white blood cell antigen allele (type of DNA sequence). HLA-B*1502 is primarily found in people of Asian descent. The FDA recommends that doctors replace Dilantin use with carbamazepine, which is sold under the names Tegretol, Biston, and Calepsin.
Dilantin has recently been associated with Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis Syndrome (TENS). SJS and TENS are dramatic reactions affecting the skin and mucous membranes, causing blisters, swollen eyelids, severe burning, and possibly death of the affected skin. They can cause blindness, lung damage, asthma and even death.
Prednisone and other steroid anti-inflammatory drugs are used to treat SJS, however the effectiveness of this treatment is in question.