Patients who experienced cerebellar atrophy due to phenytoin toxicity while taking Dilantin may be eligible for compensation.

What is Dilantin?

Dilantin (phenytoin) is an epilepsy drug commonly used to treat grand mal seizures, complex partial seizures, and to prevent seizures that may happen during or after brain surgery. Dilantin can also be used to treat symptoms of anxiety, depression, bipolar disorder, aggressive behavior, Tourette’s syndrome, ADHD, and other psychological conditions.

According to the U.S. Food and Drug Administration, phenytoin, the active ingredient in Dilantin, works by stabilizing the neurological response to excessive stimulation and environmental changes, which are common triggers for epileptic episodes.

Phenytoin was first developed as a barbiturate derivative in 1908 by prominent German chemist Heinrich Biltz. He sold his patent to Parke-Davis (today a division of Pfizer), but no practical use for the product was found until 1938. It was at that time that two independent researchers discovered that phenytoin could be used to control seizures without sedating the patient, as was the case with phenobarbital.

Phenytoin was approved in the U.S for the treatment of epileptic seizures in 1953.

Phenytoin Mechanism of Action

Epilepsy is a general term for any condition that causes a person to experience seizures, however, the diagnosis is usually made only after the patient has experienced seizures multiple times. The causes of congenital epilepsy are not fully understood, according to WebMD, although in many cases, it is triggered by a brain injury. It may also be caused by oxygen deprivation during birth, brain tumors or infections (i.e., meningitis or encephalitis), stroke, a chemical imbalance or substance abuse. Nonetheless, a clear cause is identifiable in only 3 out of 10 cases.

A seizure is, in essence, an electrical storm in the brain; it happens when electrical impulses pass through sodium channels (communication lines between neurons) in the brain in an uncontrolled manner. Phenytoin works to temporarily shut down these channels by binding to the molecules involved, basically closing the gate.

Side Effects and Consequences of Phenytoin Toxicity

Despite the many uses and benefits patients receive from being treated by Dilantin, the drug may do more harm than good. Studies have shown that long-term use of Dilantin can lead to phenytoin toxicity and eventual cerebellar atrophy.

About Cerebellar Atrophy

Cerebellar atrophy is a degenerative condition that affects the cerebellum. Common causes of cerebellar atrophy include stroke, multiple sclerosis (MS), tumors, seizures, and other cerebellar disorders. The degenerative condition has also been linked to toxins from ethanol, chemotherapy, and Dilantin. Cerebellar atrophy involves the degeneration of brain tissue, loss of neurons, and loss of neurological connections. When the neurons in your cerebellum cannot communicate with each other and other parts of the brain, cerebellum function is diminished.

The cerebellum is the round structure that sits at the base of the spine, behind the brain stem. The cerebellum helps regulate voluntary movements such as posture, balance, coordination, and speech. A properly working cerebellum allows for smooth, balanced, and precise movements.

Damage to the cerebellum, such as from phenytoin toxicity-induced atrophy, can result in general unsteadiness. Symptoms of cerebellar atrophy are similar to those of a stroke. These symptoms include lack of balance, slow movements, unsteady or lurching walk, tremors, shaking, unstable eye movements, slow or slurred speech, and memory loss.

Research on Phenytoin Toxicity

According to Dilantin studies, cerebellar atrophy due to phenytoin toxicity tends to show up in patients after long-term use of Dilantin and typically occurs when the drug serum levels are above the recommended therapeutic range. However, cases of cerebellar atrophy have also been recorded when drug serum levels were within the recommended therapeutic range.

Various studies have been done as far back as 1994. A 1994 study took into consideration that seizures, which Dilantin is taken to treat, can also cause cerebellar atrophy. This study found that compares to non-Dilantin exposed patients, patients on Dilantin were significantly more likely to develop cerebellar atrophy. A 2003 study found that long-term use was related to moderate to severe cerebral atrophy. Another study found that cerebral atrophy due to phenytoin toxicity can also affect children.

Recovery from phenytoin toxicity and cerebellar atrophy is possible when affected patients stop using Dilantin. Withdrawal from Dilantin and phenytoin toxicity should be monitored by a doctor. In some cases, when Dilantin treatment is chronic, some injuries are permanent, specifically a lack of muscle coordination.

Legal Issues

If you or a loved one suffer from cerebellar atrophy caused by phenytoin toxicity, you may have a legal claim. A Dilantin cerebellar atrophy lawsuit could recover compensation for medical bills, loss of wages, permanent disability, pain and suffering, and more.