DIPHENYLHYDANTOIN (Dilantin) sodium was synthesized in 1908 by Biltz1 and introduced as an antiepileptic agent in 1938 by Merritt and Putnam.2 Extensive subsequent use of this drug has confirmed its efficacy in controlling epileptic seizures, particularly major motor (grand mal) convulsions.
A number of untoward reactions have been observed in patients receiving diphenylhydantoin,3 one of the most common being hyperplastic enlargement of the gingivae.
The prime purpose of this writing is to discuss this reaction in general and, more importantly, to designate the types of patients with epilepsy in whom, because of this reaction, we believe the use of diphenylhydantoin as the drug of first choice is contraindicated.
The information presented in this paper is based on direct clinical observations of approximately 15,000 patients of all ages who were studied in our clinic while receiving this drug and, also, on an extensive review of the literature.
Livingston S, Livingston HL. Diphenylhydantoin Gingival Hyperplasia. Am J Dis Child. 1969;117(3):265–270. doi:10.1001/archpedi.1969.02100030267002
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