Does long-term phenytoin have a place in Dravet syndrome?

George A Zographos, Sophie J Russ-Hall, Ingrid E Scheffer

Annals of clinical and translational neurology 2022 Oct 31

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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. © 2022 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association.

Citation

George A Zographos, Sophie J Russ-Hall, Ingrid E Scheffer. Does long-term phenytoin have a place in Dravet syndrome? Annals of clinical and translational neurology. 2022 Oct 31;9(12):2036-2040