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October 1968

Acute Diphenylhydantoin Intoxication

Author Affiliations

From the departments of medicine (Drs. Tenckhoff and Sherrard) and pediatrics (Drs. Hickman and Ladda), University of Washington, Seattle.

Am J Dis Child. 1968;116(4):422-425. doi:10.1001/archpedi.1968.02100020426015

DIPHENYLHYDANTOIN (Dilantin), the most commonly used anticonvulsant, has a remarkable safety record.1 As much as 25 gm of the drug has been ingested (18-year-old epileptic girl) without major ill effects or serious sequelae.2 Whereas mild toxic reactions, usually from chronic overdosage, are fairly common, serious intoxications are infrequent. Apart from fatalities due to hypersensitivity reactions, a search of the literature revealed only three reported deaths from intoxication and central nervous system (CNS) depression.3-5 Taking into consideration that many actual incidents of drug reaction are not reported,6 it is likely that many more patients have died from diphenylhydantoin intoxication.

In 1966 a fatal case of diphenylhydantoin poisoning was reported from this hospital.5 Recently we had the opportunity to observe another child with serious intoxication. After three days in coma with decerebrate rigidity, the child was transferred to the University Hospital. We are reporting this case because of

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