Irreversible Cerebellar Atrophy as a Complication of Short-Term Phenytoin Exposure: Clinical Improvement Following Discontinuation of the Culprit.
Irreversible Cerebellar Atrophy as a Complication of Short-Term Phenytoin Exposure: Clinical Improvement Following Discontinuation of the Culprit.
复制标题
DOI：
10.14581/jer.20016
复制
发表时间：
2020-12
期刊：
影响因子：
--
通讯作者：
Al-Malki AQ
中科院分区：
文献类型：
--
作者：
Algahtani H;Shirah B;Alqahtani AJ;Al-Malki AQ
苯妥英（二苯基乙内酰脲）是一种广泛使用的抗癫痫药物，用于控制全身性和部分性癫痫发作。可逆性小脑症状，包括小脑共济失调，多年来一直被认为是苯妥英钠使用的不良事件。另一方面，在接受该药物治疗的癫痫患者中，已报告了小脑变性。我们报告一个有趣的病例，苯妥英引起急性全小脑综合征，神经影像学显示小脑萎缩，停药多年后改善。苯妥英停药可能会给病人一个机会，在停药后几个月慢慢恢复。神经科主治医师应向患者及其家属介绍提示药物毒性的常见临床表现，并定期进行随访和临床检查。
Phenytoin (diphenylhydantoin) is a widely used antiepileptic drug for controlling both generalized and partial seizures. Reversible cerebellar symptoms, including cerebellar ataxia, have been recognized as an adverse event of phenytoin use for many years. On the other hand, cerebellar degeneration has been reported with chronic use in an epileptic patient treated with this drug. We are reporting an interesting case of phenytoin induced acute pan-cerebellar syndrome with cerebellar atrophy on neuro-imaging that improved many years after discontinuation of the drug. Discontinuation of phenytoin may give a chance for the patient to recover slowly, months after stopping the drug. It is very important for the attending neurologist to educate the patients and their families on some common clinical manifestations suggestive of drug toxicity and perform a regular follow-up and clinical examination at regular intervals.