Intravenous Diphenylhydantoin in Experimental Seizures

Abstract

DIPHENYLHYDANTOIN, used orally, is one of the most effective drugs available for the prevention of seizures. The oral or intramuscular routes of administration require the passage of hours to days, however, to achieve therapeutic blood levels, even when large loading doses are used. 1-5 For these reasons, the availability of an intravenous preparation of diphenylhydantoin for status epilepticus, was welcomed. Recent studies from our laboratories, showed that as much as 1,000 mg could be given safely to patients by the intravenous route, provided certain precautions were observed. 6 Well-sustained blood levels of diphenylhydantoin were achieved rapidly with this dosage without producing deep sedation. However, only limited success has been achieved with the use of intravenous di-phenylhydantoin in status epilepticus in man. 2,6,7 Controversy exists in the reported effects of the drug in stopping experimental seizures in animals. 8,9 In an effort to understand the reasons for failure or