Does long‐term phenytoin have a place in Dravet syndrome?
Open accessAbstract
Anti‐seizure medications that block sodium channels are generally considered contraindicated in Dravet syndrome. There is, however, considerable debate about the sodium‐channel blocker phenytoin, which is often used for status epilepticus, a frequent feature of Dravet syndrome. We describe four patients with Dravet syndrome in whom long‐term phenytoin therapy reduced seizure frequency and duration. In two patients, phenytoin produced prolonged periods without status epilepticus for the first time. Attempting to wean phenytoin in all patients after 1 to 20 years of use resulted in seizure exacerbation. Reintroducing phenytoin improved seizure control, suggesting phenytoin is beneficial in some patients with Dravet syndrome.
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The SCB topiramate can be useful in Dravet syndrome, whereas others, such as lamotrigine and phenytoin, may exacerbate seizures in some patients and be helpful in others.
“However, the SCB topiramate can be useful in Dravet syndrome 181 , whereas others, such as lamotrigine and phenytoin, may exacerbate seizures in some patients and be helpful in others 208,209 .”
From Developmental and epileptic encephalopathies (2024) · cites this paper as [209]
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Cites
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- Authors
- Zographos, G. A., Russ‐Hall, S. J., & Scheffer, I. E.
- Affiliations
- The University of Melbourne (AU)
- Epilepsy Research Centre, Department of Medicine University of Melbourne, Austin Health Melbourne Australia
- Royal Children's Hospital (AU)
- Corresponding author
- Scheffer, Ingrid E.
- Venue
- Annals of Clinical and Translational Neurology
- Publisher
- Wiley
- Published
- 2022-10-31
- Volume
- 9
- Issue
- 12
- Pages
- 2036-2040
- ISSN
- 2328-9503 (ISSN-L)
- PMC
- PMC9735367
- OpenAlex
- W4307687744
- Cited by
- 17
- References
- 21
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 2 · 2023: 3
- FWCI
- 1.95
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Annals of Clinical and Translational Neurology (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by-nc-nd)
- Funders
- National Health and Medical Research Council (GNT1172897, GNT2006841, GNT2010562)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Epilepsy research and treatment
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmacological Effects and Toxicity Studies
- Health Sciences › Medicine › Physiology › Diet and metabolism studies
- Keywords
- Dravet syndrome, phenytoin, sodium channel blockers, status epilepticus, seizure frequency, long-term antiepileptic therapy, seizure exacerbation, seizure control
- MeSH terms
- Epilepsies, Myoclonic, Humans, Phenytoin, Seizures, Status Epilepticus, Sodium Channels
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