Noncompliance leading to drug accumulation resulting in phenytoin toxicity.

Phenytoin is effective in suppressing tonic-clonic and partial seizures, and is widely used for initial therapy, particularly in adults. Ninety percent of phenytoin is protein bound and entirely eliminated by hepatic metabolism. The major metabolite of phenytoin, 5-(p-hydroxyphenyl)-5phenylhy-dantoin (5HPPH) is excreted in the urine.