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Phenytoin is a hydantoin compound related to the barbiturates that are used for the treatment of seizures. It is an effective anticonvulsant for the chronic treatment of tonic-clonic (grand mal) or partial seizures and the acute treatment of generalized status epilepticus (Table 10-1).1,2,3, and 4 After generalized status epilepticus has been controlled with intravenous benzodiazepine therapy and supportive measures have been instituted, phenytoin therapy is often immediately instituted with the administration of intravenous phenytoin or fosphenytoin. Orally administered phenytoin is used chronically to provide prophylaxis against tonic-clonic or partial seizures. Phenytoin is a type 1B antiarrhythmic and is also used in the treatment of trigeminal neuralgia.

TABLE 10-1International Classification of Epileptic Seizures With Recommended Therapies

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