Chronic phenytoin use

Case contributed by Dr Hein Els


Long term phenytoin use for seizure disorder.


Cerebellar atrophy and hyperostosis of the calvarium.

Case Discussion

Long term use of anti-seizure medications can produce CNS complications. Phenytoin is a frequently prescribed anti-seizure medication that may cause cerebellar atrophy and hyperostosis of the calvarium.

The cause of cerebellar atrophy in patients with a seizure disorder may be due to:

  • seizure mediated cell loss
  • side effect of the anti-seizure medication
  • combination of above factors

There are various causes of calvarial thickening, but the combination with cerebellar atrophy in this patient with a history of long term phenytoin use favors phenytoin as the cause.

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Case information

rID: 45609
Published: 31st May 2016
Last edited: 14th Aug 2019
Tag: skull
Inclusion in quiz mode: Included

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