Ataxia, Manifestation of Phenytoin Toxicity: A Case Report

Abstract

Phenytoin is a choice of drug for the treatment of epilepsy. It is categorized under drugs with narrow therapeutic range. Adverse effects of phenytoin observed in patients are gum hypertrophy, dystonia, myoclonus, abnormal muscle movement and rarely ballismusand ataxia. We report a case of a 32-year-old female, who had chief complaints of ataxia, oscillopsia, dizziness and nausea. She had past medical history of epilepsy and was taking phenytoin from the past 10 years. Treatment was started after tapering the dose of phenytoin, finally discontinuing, she was prescribed with valproic acid as an alternative for phenytoin. Present case report describes the phenytoin toxicity that helps to create awareness among physicians. There should be proper monitoring of plasma concentration of phenytoin to avoid its toxicity in the patients on chronic drug therapy so that drug dosage can be tailored as per the pharmacokinetic needs of the patient.

Levetiracetam and cutaneous adverse reactions: A systematic review of descriptive studies

“…Commonly known adverse effects of LEV include somnolence, headache, dizziness, asthenia, infection, pharyngitis, anorexia, cough and rash [5]. Toxic epidermal necrolysis (TEN), Steven-Johnson syndrome (SJS) and drug reaction with eosinophilia and systemic T symptoms syndrome (DRESS) are the serious fatal cutaneous reactions associated with AEDs such as lamotrigine (LTG), carbamazepine (CBZ), phenytoin (PHY), valproic acid (VPA) and rarely associated with second-line drugs such as LEV as per the post-marketing surveillance reports and these cutaneous adverse drug reactions (CADRs) are most commonly seen with aromatic AEDs [6][7][8].…”