Abstract
Phenytoin is a broad acting sodium channel blocker we deem fit for topical formulations to treat localized peripheral neuropathic pain. We tested this cream in a number of patients suffering from neuropathic pain syndromes and found it to be especially of use in small fiber neuropathic pain and in painful diabetic neuropathy. The fact that patients report an onset of action within 30 minutes, and the absence of detectable plasma levels of phenytoin, support an intra-epidermal mechanism of action. In this paper, we launch a hypothesis why phenytoin might be of particular use in peripheral neuropathic pain syndromes such as painful diabetic neuropathy
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