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Adverse cognitive effects of phenytoin in severe brain injury: a case report.

Author(s): Pinder C, Young C

Affiliation(s): The Walton Centre NHS Foundation Trust, Fazakerley, Liverpool, UK. colin.pinder@nhs.net

Publication date & source: 2011, Brain Inj., 25(6):634-7.

Publication type: Case Reports; Review

BACKGROUND: The use of prophylactic anticonvulsants following brain injury is controversial. When used for this reason or for treatment of early seizures, anticonvulsants, particularly phenytoin, can cause severe cognitive side-effects. CASE REPORT: This study presents a case of a woman with a severe brain injury with severe cognitive impairment who improved dramatically following withdrawal of phenytoin. The literature regarding such cognitive side-effects is contradictory with no consistent indication of choice of anticonvulsants to use in this situation. CONCLUSION: As a result of the dramatic improvement in this case, one should now routinely withdraw or change phenytoin treatment in all brain injury patients with significant cognitive impairment.

Page last updated: 2011-12-09

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