title: Adverse cognitive effects of phenytoin in severe brain injury: a case report.
abstract: BACKGROUND
  The use of prophylactic anticonvulsants following brain injury is controversial. When used for this reason or for treatment of early seizures, anticonvulsants, particularly phenytoin, can cause severe cognitive side-effects.
  
  
  METHODS
  This study presents a case of a woman with a severe brain injury with severe cognitive impairment who improved dramatically following withdrawal of phenytoin. The literature regarding such cognitive side-effects is contradictory with no consistent indication of choice of anticonvulsants to use in this situation.
  
  
  CONCLUSIONS
  As a result of the dramatic improvement in this case, one should now routinely withdraw or change phenytoin treatment in all brain injury patients with significant cognitive impairment.
authors.affiliation: The Walton Centre NHS Foundation Trust, Fazakerley, Liverpool, UK. colin.pinder@nhs.net
authors.forename: Colin
authors.initials: C
authors.lastname: Pinder
authors.forename: Carolyn
authors.initials: C
authors.lastname: Young
mesh_terms: D000927:Anticonvulsants / Q000009:adverse effects*; D001930:Brain Injuries / Q000150:complications*; D004834:Epilepsy, Post-Traumatic / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010672:Phenytoin / Q000009:adverse effects*; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants; D010672:Phenytoin