A rare side effect of Dilantin can lead to a condition called cerebellar atrophy, impairing a patient’s ability to control both large and small movements.

In an era with so many new medications hitting the market, Dilantin has a comparatively long history. It’s been referred to as the “grandfather of all epilepsy medications.”

It was originally developed over a hundred years ago as a treatment for the convulsions that sometimes happened during electroshock therapy.

By 1940, Dilantin’s ability to treat seizures had been documented. It was then thought to be the first in what would become a new generation of epilepsy medications. The FDA formally approved Dilantin as a seizure treatment in 1953.

Since then, Dilantin is now mostly used to treat just a few specific types of seizures – namely, generalized and partial tonic-clonic seizures and complex partial seizures, also known as psychomotor or temporal lobe seizures. It is also used to treat seizures that sometimes accompany neurosurgery.

Though it’s now considered a second-line treatment in most cases, Dilantin is still one of the most frequently used drugs in the world.

Cerebellar Atrophy as a Side Effect of Dilantin

Patients prescribed Dilantin over the long term may end up developing cerebellar atrophy as a side effect of Dilantin.

Cerebellar atrophy is a kind of focal cerebral atrophy that degrades the tissue within the cerebellum, the part of the brain that has a lot of responsibility for control of movement.

Patients suffering from cerebellar atrophy tend to develop symptoms related to voluntary muscle movement – a set of symptoms that is sometimes referred to as ataxia.

A characteristic symptom of cerebellar atrophy is difficulty walking. Patients may exhibit a walk that is unsteady, and they may stagger or trip, especially on moving surfaces like escalators or boat decks. They may generally have trouble keeping balance and maintaining their posture.

Patients also suffer from loss of finer motor control. Activities like writing, typing, putting on clothes or preparing food may be affected.

The patient may also have difficulty forming clear speech, making communication difficult; or they may also have difficulty swallowing food, creating a possible choking risk.

Cerebellar atrophy symptoms resulting as a side effect of Dilantin aren’t limited to just physical problems, though. They can also manifest as emotional or cognitive problems. Patients may suffer from anxiety, depression, or irritability.

In the cognitive realm, they may have trouble recalling previously learned information or implementing executive functions like making plans or keeping thoughts in order.

The first step in treating cerebellar atrophy is to remove the cause – so if the condition is a side effect of Dilantin, the patient will need to discontinue that drug and maybe switch to a different anticonvulsant.

Treating the symptoms of cerebellar atrophy can be complex. Many different types of care providers may be needed to help address all aspects of the condition. Physical therapy can help restore balance, coordination and posture.

An occupational therapist may help the patient adapt to their loss of function in the workplace, sometimes by recommending adaptive equipment that helps mitigate the patient’s loss of function.

Speech therapy may be necessary to restore the patient’s ability to communicate verbally.