Recent scientific studies have found long-term use of the anti-seizure medication Dilantin is likely among the causes of cerebellar atrophy, a neurodegenerative disorder that can result in memory loss and impaired coordination and movement.

Other side effects can include slurred speech and a condition known as nystagmus, characterized by rapid, uncontrollable eye movement.

About Dilantin

Dilantin (phenytoin, or PHT) was first developed by German chemist Heinrich Biltz in 1908. Biltz then sold the patent to Parke-Davis (now a subsidiary of Pfizer), but it was another 20 years before medical science determined its usefulness for controlling seizures.

Dilantin received approval from the U.S. Food and Drug Administration (FDA) way back in 1953. However, in 2008 — more than 50 years after its initial approval — the FDA placed Dilantin on its Potential Signals of Serious Risks listing, calling for more testing and evaluation.

Despite the FDA listing and desire for more testing, Dilantin or phenytoin is one of the least expensive anticonvulsant medications available worldwide. Dilantin sells at the wholesale level in the developing world at the equivalent of between $0.15 and $0.30 per dose or an average of $30 a month.

Phenytoin remains on the World Health Organization’s (WHO) List of Essential Medications — those medications that are believed to be the safest and most effective for what they do and inherently needed in any healthcare environment. It is used to treat what were formerly known as grand mal seizures — now renamed tonic-clonic — as well as focal seizures. Absence seizures do not respond to this treatment.

Approximately 1.5 million prescriptions were written for Dilantin in 2019 alone, per ClinCalc.com. However, Dilantin it is not the first course of treatment among specialists given the range of newer anticonvulsants on the market with fewer side effects.

Serious side effects commonly associated with Dilantin are narcolepsy, liver disorders, hypotension and a dermal condition known as toxic epidermal necrolysis (the surface of the skin begins to die and peel away). Although rare, a few patients on anticonvulsants may have suicidal ideation with major depression.

It also accumulates in the cerebellum region of the brain, where over time, it may end up causing cerebellar atrophy.

Cerebellar atrophy (atrophy of the brain) is a condition in which the brain tissue degenerates, meaning that brain cells are being lost. This can include a number of symptoms, including:

• Unsteady, lurching walk, often including a back-and-forth tremor in the body
• Slow, unsteady, or jerky movements in the limbs
• Slow, slurred speech
• Nystagmus (small, rapid movements in the eyes)
• Memory loss
• More

If you experience any of the symptoms indicative of the above, it is a good idea to advise your caregiver or prescribing physician.

Less serious side effects of Dilantin, according to WebMD, should be monitored only if they become so frequent as to interfere with lifestyle or worsen over time. These include constipation, nausea, dizziness, vomiting, vertigo, insomnia, or a persistent feeling of anxiety or nervousness.

Dilantin and cerebellar atrophy

Studies identifying long-term Dilantin use as one of the causes of cerebellar atrophy date back to at least 2003. Its exact mechanism of action is not known, but a 2004 review of antiepileptic drugs published in the journal Nature Reviews Neuroscience indicates that it essentially blocks the “voltage gated sodium ion channels” that regulate the flow of bio-electrical signals between brain cells.

When the cerebellum atrophies, the neurons, or nerve cells in the brain, begin to die off. Because this is the part of the brain that controls voluntary muscle movement, the most common outward manifestations include an unsteady, lurching gait along with lateral tremors in the torso and sudden, jerky movements of the limbs. A person suffering from cerebellar atrophy often appears to be intoxicated.

A 1994 study published in Archives of Neurology found that patients who had taken Dilantin to control epileptic seizures “had significantly smaller cerebelli.”

Other causes of cerebellar atrophy

There are many other potential causes of cerebellar atrophy, other than Dilantin exposure. Cerebellar atrophy may also be the result of stroke, inflammatory diseases affecting the brain such as bovine spongiform encephalopathy (“Mad Cow” disease), multiple sclerosis, alcoholism or genetic conditions like ataxias (an inherited disease affecting neuromuscular function).

Although there are multiple causes of cerebellar atrophy, the condition is incurable. Once the damage is done, there is nothing that can restore the damaged neurons. Depending on the causes of cerebellar atrophy, there are treatments that can slow its progression and mitigate the worst of the symptoms.

Withdrawal from Dilantin

Dilantin is the only one among the causes of cerebellar atrophy in which brain injury can be limited by removing the patient from the drug. Anecdotal reports suggest that some Dilantin patients whose cerebellar atrophy is localized experience some degree of recovery when the medication is discontinued.

However, if they have been taking Dilantin for an extended time, damage to the cerebellum may be extensive and irreversible, and the movement disorder (ataxia) may remain. It is important to note that epilepsy itself can cause atrophy of this part of the brain, so it is not the only cause in a person presenting a seizure disorder.

Secondly, no anticonvulsant medication should be discontinued without first seeking medical advice. The danger in having uncontrolled seizures can often be greater and more likely than many side effects.

Filing a Dilantin lawsuit

A growing number of people are coming forward with claims of Dilantin cerebellar atrophy. Lawsuits have led, in some cases, to significant settlements and rewards.

If you or someone you love has suffered from cerebellar atrophy after exposure to Dilantin (especially long-term), you may be able to file a lawsuit and pursue compensation. Filing a lawsuit cannot take away the pain and suffering caused by such injuries, but it can at least help to alleviate the financial burden incurred by medical expenses, lost wages, and more, as well as hold those responsible accountable for their actions and inactions.

Filing a lawsuit can be a daunting prospect, so Top Class Actions has laid the groundwork for you by connecting you with an experienced attorney. Consulting an attorney can help you determine if you have a claim, navigate the complexities of litigation, and maximize your potential compensation.