The anti-seizure medication Dilantin (phenytoin) has been linked to a neurodegenerative condition known as cerebellar atrophy, but some symptoms are treatable, according to physicians at Johns Hopkins.

One of the most visible symptoms of this atrophy is ataxia, which affects the victim’s voluntary muscle control.

In a limited number of cases, the progression of ataxia has been slowed or stopped with the use of certain prescription drugs. Those suffering from Dilantin-related cerebellar atrophy may benefit by stopping the medication.

The Dilantin-Cerebellar Atrophy Connection

Cerebellar atrophy is a shrinking of the cerebellum, the part of the brain involved in motor control. It can have any number of causes, including stroke, multiple sclerosis, and chronic seizures. It can also result from chemical toxicity, including alcohol, chemotherapy drugs, and long-term Dilantin use.

As far as Dilantin is concerned, the effect appears to be cumulative; in general, the longer a patient has been taking the drug, the more likely they will suffer from atrophy of the cerebellum. This has been confirmed by studies that have found the condition to be more common in subjects who have been using Dilantin on a long-term basis. It also occurs when levels of the drug are above the recommended therapeutic range.

Symptoms of Cerebellar Degeneration

Because the cerebellum controls voluntary muscle movement, cerebellar atrophy is characterized by motion disorders. The most obvious is ataxia. This condition is characterized by a slow, unsteady, lurching walk and is frequently accompanied by a back and forth tremor of the chest and abdomen as well as unsteady, jerking motions of the limbs.

Other symptoms may include slow, slurred speech and a condition known as nystagmus, which manifests as small, rapid eye movements.

Ataxia may also be caused by a deficiency of Vitamin E or coenzyme Q10, which is usually produced naturally in the body. In these cases, ataxia is highly treatable and can even be reversed by addressing these deficiencies. However, only a consultation with a neurologist can determine the exact cause of ataxia.

Treatments

In most cases, this atrophy is permanent and irreversible. When the condition is related to Dilantin use, if it is caught early on and remains localized in one small area of the cerebellum, withdrawing the patient from the medication can stop the degeneration. In some cases, removing a patient from Dilantin can even reverse the symptoms. Withdrawal from Dilantin should only be done under the prescribing physician’s supervision.

In most cases, however, the damage is permanent. That said, the ataxia that results from cerebellar degeneration can be managed with a combination of therapies. It is recommended that ataxia victims continue to exercise their bodies as well as their minds and maintain healthy eating and sleeping habits while avoiding exposure to communicable diseases.

Medications that are typically used to treat ataxia include amantadine, a dopamine-promoting prescription drug used to treat symptoms of Parkinson’s Disease, and baclofen, a medication for managing leg spasms. Other prescription medications that may ease ataxia symptoms are clonazepam, an anti-anxiety drug, and beta blockers.