Wednesday, November 8, 2017

Q: 28 year old female is admitted to ICU with exacerbation of  multiple sclerosis (MS) and optic neuritis. Which of the following anti-seizure drug is found to be neuroprotective in optic neuritis, and has been suggested as an adjuvant treatment in patients with MS who suffered from optic neuritis?

A) Klonopin
B) Levetiracetam
C) Phenytoin
D) Lorazepam
E) Phenobarbital

Answer: C

Inhibition of voltage-gated sodium channels is found to be neuroprotective in preclinical models. Assuming this mechanism of action, sodium-channel inhibition with phenytoin is suggested to be neuroprotective in patient with acute optic neuritis.


1. Raftopoulos R, and et al -  Phenytoin for neuroprotection in patients with acute optic neuritis: a randomised, placebo-controlled, phase 2 trial. - Lancet Neurol. 2016 Mar;15(3):259-69

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