Summary

Phenytoin has been found effective in the treatment of so many types of pain that it is useful as a general pain medication. PHT’s usefulness in pain is enhanced by the fact that it is not sedative and it is not habit-forming. It can be used alone or in combination with narcotics and other pain medications.

PHT’s first use in pain, for trigeminal neuralgia, was reported in 1942 by Bergouignan. Since then, PHT has been reported useful for facial and head pain, including trigeminal and glossopharyngeal neuralgia; peripheral nerve neuralgias and neuropathic pain, including that of polyneuritis, late-stage syphillis, diabetic neuropathy, Fabry’s disease, and post-herpetic and postsympathectomy pain states; migraine and other headache; postoperative pain; phantom limb pain; pain of skeletal muscle spasms; post-stroke pain; and pain caused by malignant disease.

In recent years, used topically, in addition to speeding healing, PHT has been shown to rapidly decrease pain of ulcers, burns and wounds. Initial messages of pain are necessary protective mechanisms. PHT does not interfere with these initial bioelectrical impulses, but it does reduce repetitive neuronal activity, as in post-tetanic afterdischarge.

Advisory