K K Jain MD (Dr. Jain is a consultant in neurology and has no relevant financial relationships to disclose.)
Originally released December 18, 1998; last updated September 16, 2020; expires September 16, 2023

Historical note and terminology

The era of antiepileptic drugs started with the introduction of bromides in 1857 and was followed by the discovery of the anticonvulsant effect of barbiturates in 1912. Hydantoins, structurally like barbiturates, followed as second generation antiepileptic agents. The main action of hydantoins is to prevent the spread of seizure activity by stabilizing the neuronal membranes through modulating ion fluxes. Phenytoin (diphenylhydantoin) was synthesized in 1908 (Biltz 1908) and was introduced in the treatment of epilepsy in 1938 (Merritt and Putnam 1938).

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