Patients with epilepsy who take high doses of Dilantin or take the anti-seizure medication for a long time might suffer atrophy of the cerebellum.

Movement and coordination are controlled by the cerebellum, which sits at the base of the brain just behind the brain stem. The cerebellum is divided into two hemispheres and controls posture, balance and speech.

When atrophy of the cerebellum occurs, that part of the brain experiences a loss of neurons and the connections among them. As the neurons hit and miss during their attempts to connect, the body might exhibit several different symptoms, including:

• A swaying or stumbling gait; a walk similar to that of a drunk person
• An uncontrollable bobbing motion of the trunk or head as the patient tries to sit still
• Incapable of reaching an intended position with the hand, arm, leg or eye
• Difficulty with daily activities, such as brushing teeth, tying shoes or buttoning clothing
• Slurred or monotone speech
• Visual difficulties
• Rapid, uncontrollable eye movements

Dilantin and Atrophy of the Cerebellum

In 1994, researchers observed patients who took Dilantin and a control group that had never taken the anti-convulsant. Brain imaging showed that the cerebelli of those who took Dilantin were much smaller than that of those who were never treated with Dilantin.

Moreover, the severity and incidence of the atrophy of the cerebellum was associated with the dosing of Dilantin they ingested.

In fact, the study showed that atrophy of the cerebellum is more likely when the blood’s drug serum levels are beyond the therapeutic range and when Dilantin is taken for a long period of time. Many patients with epilepsy need a lifetime of keeping the seizures at bay.

Patients who are elderly experience an increased risk of Dilantin toxicity that can lead to atrophy of the cerebellum. Medications taken for abnormal heart rhythms, ulcers, tuberculosis and alcoholism also can increase the risk of Dilantin poisoning.

Other physical ailments can result in atrophy of the cerebellum. Any patient suffering a stroke, multiple sclerosis, brain tumors and even seizures themselves, can cause the cerebellum to become injured.

If symptoms of atrophy of the cerebellum are detected early, the patient has a chance to recover to a certain extent. The most difficult injury to overcome is the lack of muscle coordination, which is almost always permanent.

If you have suffered any signs of atrophy of the cerebellum, contact your doctor immediately. Sometimes reducing or eliminating the medication can result in symptoms subsiding.

Your doctor can analyze your seizure history, Dilantin dosages and immediate symptoms to decide how to treat your individual situation. Sometimes, physical therapy or occupational therapy can improve coordination.

In addition to undergoing blood tests to determine the level of Dilantin in your blood, your doctor might order an MRI of your brain to visualize the cerebellum and determine if atrophy of the cerebellum has occurred.