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June 1, 1960Archives of Neurology278 citations

Clinical and Electroencephalographic Correlations with Serum Levels of Diphenylhydantoin

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FBFritz BuchthalOSOle SvensmarkPSPoul J. Schiller

Key Points

  • To evaluate the relationship between serum concentrations of diphenylhydantoin and its clinical anticonvulsant efficacy, electroencephalographic changes, and toxic side effects.
  • Evaluated 12 hospitalized patients (6 men and 6 women, aged 19 to 58 years) with no prior history of diphenylhydantoin therapy.
  • Measured serum drug levels following oral and intravenous administration and tracked paroxysmal abnormalities using electroencephalograms (EEG).
  • Serum concentrations of diphenylhydantoin correlate with therapeutic anticonvulsant control and suppression of paroxysmal EEG abnormalities.
  • Higher serum drug concentrations are directly associated with the emergence of clinical toxic side effects.

Abstract

In a previous study2a method was described for determining diphenylhydantoin (5,5-diphenylhydantoin; phenytoin; Dilantin) concentrations in the serum when the drug was given in therapeutic amounts. With this method were determined the rate of rise of diphenylhydantoin in the serum after oral and after intravenous administration, the hourly and daily fluctuations, the ratio of dosage to serum level, and the rate of fall of serum diphenylhydantoin after withdrawal of the drug. In the study presented in this report the correlation is described between the serum level of diphenylhydantoin and the anticonvulsant effect of the drug, the incidence of paroxysmal abnormalities in the electroencephalogram, and the occurrence of toxic side-effects. Patients and MethodsPatients. —1. Twelve patients, 19 to 58 years of age—six men and six women, hospitalized in the neuromedical, neurosurgical, or psychiatric department of the University Hospital. They had not taken diphenylhydantoin before admission to the hospital and

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Cite This Study

Buchthal et al. (1960) studied this question.

synapsesocial.com/papers/6a6bde1a285b5e3c3db3c7dfhttps://doi.org/10.1001/archneur.1960.03840120030004
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