IT HAS BEEN shown previously that diphenylhydantoin given intravenously reaches cerebral tissue preferentially and very rapidly, irrespective of the rate of administration.1 The actual concentration accumulating in cerebral tissue is directly related to the dose infused.
Assuming a similar relationship between the dose and the cerebral concentration of diphenylhydantoin in the human, the drug ought to be effective in stopping status epilepticus, provided (A) it is given in sufficient quantity and (B) diphenylhydantoin is effective in stopping seizures. Murphy and Schwab2 reported good results in three patients. Wallis et al3 using the intravenous infusion of 1 gm of diphenylhydantoin, found that seizures could be halted in 16 of 31 patients with status epilepticus.
On the other hand, Rand et al4 found that intravenous diphenylhydantoin had no effect on the direct cortical response, the augmented direct cortical response, or induced epileptic cortical activity in paralyzed, anesthetized
Louis S, Kutt H, McDowell F. Intravenous Diphenylhydantoin in Experimental Seizures: II. Effect on Penicillin-Induced Seizures in the Cat. Arch Neurol. 1968;18(5):472–477. doi:10.1001/archneur.1968.00470350030002
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