It's basically because Dilantin is a first gen AED whereas Keppra is Second gen AED. So there always going to prefer someone goes on the newer med over the older med. Unless you really need a older one. When I was first diagnosed, I was one a second gen med then was put on Topamax which is a first gen and Tegretol which is a second gen. So, I was one of each for 25 years. Currently I'm on Keppra and Topamax.

Keppra was my first meditation and I have no clue why keppra is the usual go to for first time meds. It causes so many side effects for a lot of people and overall just not a good seizure med in my opinion. I have never been on Dilantin but I was taken off keppra roughly 3 months ago and switched to Clobazam which has been a lot better it just makes me super tired since it’s in the benzo class

When I was diagnosed in the 1970's, Dilantin was usually the first one prescribed. In fact, I recently found a script from when I was 18 months for Dilantin. It does have quite a few side effects and am sure that's among the reasons why it's no longer the first choisce for doctors these days...

They push keppra because that is a drug doctors put their patients on first. Why i don't know. When i started taking it side effects were a big problem when taking it. I had to stop taking Dilantin because of one of the side effects which was swelling of the gums. I had to see the dentist every 3 months just to remove the swelling of my gums.

Ive been on dilantin since being diagnosed in 1981, except for a short time (while pregnant) I was changed to tegretol but had seizures. I have been back on dilantin, yes I had gum problems. I feel comfortable on dilantin (seizure free), neurologist said changing meds isnt needed at this time.