Though Dilantin can effectively control some epileptic seizures, it may also put patients at risk for an entirely different movement disorder related to cerebellar atrophy.

Dilantin is one of the oldest anticonvulsant drugs still used today to control epileptic seizures.

It was originally created over a hundred years ago to prevent convulsions in patients undergoing electroshock therapy. By the 1940s, it was recognized as an effective way to keep some types of epileptic seizures under control.

Today, though it’s not the treatment of choice for every type of seizure, Dilantin is one of the most widely used drugs in the world.

Yet despite its popularity, some research links the drug to cerebellar atrophy, a type of focal cerebral atrophy that attacks the part of the brain that controls movement.

In one study, researchers examined brain imaging studies from 56 epilepsy patients who had used phenytoin (the generic name for Dilantin) for at least two months.

They found that cerebellar atrophy was frequently associated with long-term phenytoin use.

The researchers noted that although the duration of patients’ epilepsy may also have an effect on the cerebellar atrophy, that effect was clearly less important than the length of time the patient had taken phenytoin.

Another study details the experience of a boy who developed cerebellar atrophy after years of Dilantin use.

After he complained to his doctors that he had difficulty walking, his doctors also noted other cerebellar atrophy symptoms like abnormal movement of the trunk, limbs and eyes.

Imaging studies confirmed his cerebellum had degenerated, and a causal analysis showed his cerebellar atrophy was probably associated with phenytoin.

Cerebellar Atrophy Symptoms

Since the cerebellum controls movement, degeneration of the cerebellum can lead to problems controlling voluntary muscle movement. These cerebellar atrophy symptoms can be collectively known as ataxia.

Ataxia can significantly affect a person’s ability to carry out regular activities of daily living. A person with ataxia may have difficulty walking due to a loss of balance and coordination.

Everyday activities that require fine motor skills can become difficult – activities like writing, typing, buttoning a shirt, or preparing food.

The loss of coordination can affect the mouth and throat in a way that alters speech. A person with ataxia may speak slowly, indistinctly, or with an abnormal rhythm. They may also have difficulty swallowing food or liquids, putting them at risk for choking.

In addition to impairment of muscle coordination, cerebellar ataxia symptoms can also be psychological.

The cerebellum has a role to play in thought and emotion, in addition to its job of controlling movement, so degeneration of the cerebellum can impair both cognitive and emotional functioning.

Some cerebellar atrophy patients have reported problems with tasks known as “executive functions” – tasks like making plans or keeping thoughts in order. Emotional impairment can manifest with anxiety, depression or irritability.

Since cerebellar atrophy can affect so many different aspects of a person’s functioning, treatment can be complex and multimodal.

Depending on the particular symptoms, the patient could benefit from physical therapy, occupational therapy, or speech therapy, in addition to neurological treatment or psychotherapy. Adaptive devices like canes, walkers, and specially modified utensils for eating can be helpful.