Active Noncompliance as a Cause of Uncontrolled Seizures

Abstract
A 26 yr old woman with intractable seizures [epilepsy] and fluctuating plasma phenytoin concentrations was described. Noncompliance with prescribed drug regimens was suspected. Phenytoin was 1st given as a capsule and then as an elixir. Ingestion of the capsule was monitored, and active noncompliance was proved and admitted by the patient. The causes of inadequate plasma phenytoin concentrations are few and can be determined either by specific laboratory methods or by changing the form of the drug.