The effect of folic acid supplementation on the disposition of phenytoin and the resultant loss of seizure control in a male folate-deficient epileptic is reported. Due to the increase in tonic-clonic seizures after the initiation of folic acid (1 mg, orally) the sodium phenytoin dosage was increased by 130 mg until control was achieved. Because of these dosage changes, the Vmaxand Kmwere calculated before and after initiation of the folic acid. The Vmaxremained relatively the same, but the Kmdecreased after folate supplementation.
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