Is there any treatment for sensory neuropathy of the feet which has occured due to taking phenytoin for treatment for Epilepsy?

Answer 1

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Phenytoin can cause a deficiency of folate (folic acid, a vitamin) and vitamin D, occasionally leading to anemia and bone problems. Phenytoin also can produce a peripheral neuropathy, which may be felt as numbness and tingling or weakness in the feet and fingers. People who are on phenytoin for years may benefit from a daily multivitamin, since the B complex may counteract neuropathy, the D the bony changes, and the folic acid a tendency of phenytoin to reduce that vitamin.

A replacement anti-convulsant 'Keppra' has been suggested. Vitamin suppliments helped me for a while. Dilantin has controlled my seizures so well that it is hard to accept changing.

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There is now a generic Keppra. With the health care plan (Blue Cross/Blue Shield Pennsylvania) I have it runs $13 for a months supply. However, I have requested my neurologist to have the brand name since generic Keppra 500 mg can run anywhere from 400-600mg per tablet. The cost for a month's supply runs me $46. I think this is well worth the cost. I was on Dilantin for over 30 years. Side effects were high pulse rate, high blood pressure, borderline hypothyroid (needed to take meds for the thyroid and BP) and tooth sensitivity. My neurologist tried a combination of medical cocktails and the result was I was in la la land for about two months Jan-Feb 2008. We finally found a mix that works great for me. 500 mg Keppra in the morning along with 32.5 mg Phenobarbital ($4 for a month) and 1000 mg Keppra and 4 Phenobarb tablets in the evening. Since March 2008 I have been seizure free. Thanks be to God. As I was weaned from the Dilantin I was scared to death to have a seizure. The last Dilantin pill I took, March 2008, I had a seizure in which I was aware of what was going on. Very unusual for me. Since I was already under doctor's care it did not have to be reported to the commonwealth of Pennsylvania and I didn't have to start the six month wait all over again. Check with your doctor but in Pennsylvania if you are under a doctor's care and he changes the medicine and you have a seizure they don't have to report it. I had a seizure in December 2007 which started the change over to another mix. My neurologist did advise me Keppra is not meant to be monotherapy drug and should be used with another anti-seizure med. All the problems I had with my health have disappeared. I was able to quit taking BP med and thyroid med. My tooth sensitivity has disappeared. All in all it was a great change for me. Make certain you have a long talk with your doctor or specialist about all the effects of Keppra. One side effect seems to be a lack of sex drive. However after about six months it seemed to return but not as strong. Of course this drug will react differently for others.