Cerebellar volume in patients with epilepsy has been evaluated by visual inspection

Both approaches clearly show that patients with epilepsy have smaller cerebellar volumes than normal controls.

In fact, cerebellar atrophy has an estimated prevalence of between 16.2% and 30% in these patients.

In CYP2C9 mutants the maximum metabolic rate for phenytoin can be reduced by 25 54%.

The poor CYP2C9 metabolizer genotype has been associated with the development of gingival

overgrowth and cutaneous reaction in patients using this drug. In addition, some reports have suggested that use of phenytoin causes cerebellar atrophy.

This led us to hypothesize that phenytoin users who carry the CYP2C9*2 or *3 variants, including those who take normal doses of phenytoin, could have a higher blood phenytoin level and be more predisposed to cerebellar atrophy than wild type CYP2C9 phenytoin users…

cerebellar atrophy dilantin causes


The role of CYP2C9 polymorphisms in phenytoin-related cerebellar atrophy

Carlos A. Twardowschy, Lineu C. Werneck, Rosana H. Scola, Joa˜o G. Borgio, Luciano De Paola,
Carlos Silvado