Phenytoin and damage to the cerebellum – a systematic review of published cases

Ferner, Robin E; Day, Rachael; Bradberry, Sally

doi:10.1080/14740338.2022.2058487

Cited by 7 publications

(5 citation statements)

References 24 publications

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“…The search strategy included the combination of 15 movement disorders (akathisia, athetosis, bruxism, chorea, dyskinesia, dystonia, myoclonus, Parkinson or Parkinson's disease, Parkinsonism, paroxysmal dyskinesias, restless legs syndrome, stereotypy, tic, Tourette, and tremor) and 24 ASDs (brivaracetam, carbamazepine, cenobamate, clonazepam, eslicarbazepine, ethosuximide, felbamate, gabapentin, lacosamide, lamotrigine, levetiracetam, oxcarbazepine, perampanel, phenobarbital, phenytoin, pregabalin, primidone, rufinamide, stiripentol, tiagabine, topiramate, valproate, vigabatrin, and zonisamide); the last date of search was 17 April, 2022. Painful legs and moving toe syndrome and ataxia were not included among the search terms respectively because of the rarity of the disorder and the common presentation of ASD-related toxicity [6], already extensively reviewed in the literature [7] [8]. In addition, cortical myoclonus of epileptic origin was not the focus of our review as it is included among the epileptic syndromes and its treatment has been discussed elsewhere [9].…”

Section: Literature Searchmentioning

confidence: 99%

Antiseizure Drugs and Movement Disorders

Sáenz‐Farret

Tijssen

Eliashiv³

et al. 2022

CNS Drugs

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The relationship between antiseizure drugs and movement disorders is complex and not adequately reviewed so far. Antiseizure drugs as a treatment for tremor and other entities such as myoclonus and restless leg syndrome is the most common scenario, although the scientific evidence supporting their use is variable. However, antiseizure drugs also represent a potential cause of iatrogenic movement disorders, with parkinsonism and tremor the most common disorders. Many other antiseizure drug-induced movement disorders are possible and not always correctly identified. This review was conducted by searching for all the possible combinations between 15 movement disorders (excluding ataxia) and 24 antiseizure drugs. The main objective was to describe the movement disorders treated and worsened or induced by antiseizure drugs. We also summarized the proposed mechanisms and risk factors involved in the complex interaction between antiseizure drugs and movement disorders. Antiseizure drugs mainly used to treat movement disorders are clonazepam, gabapentin, lacosamide, levetiracetam, oxcarbazepine, perampanel, phenobarbital, pregabalin, primidone, topiramate, and zonisamide. Antiseizure drugs that worsen or induce movement disorders are cenobamate, ethosuximide, felbamate, lamotrigine, phenytoin, tiagabine, and vigabatrin. Antiseizure drugs with a variable effect on movement disorders are carbamazepine and valproate while no effect on movement disorders has been reported for brivaracetam, eslicarbazepine, lacosamide, and stiripentol. Although little information is available on the adverse effects or benefits on movement disorders of newer antiseizure drugs (such as brivaracetam, cenobamate, eslicarbazepine, lacosamide, and rufinamide), the evidence collected in this review should guide the choice of antiseizure drugs in patients with concomitant epilepsy and movement disorders. Finally, these notions can lead to a better understanding of the mechanisms involved in the pathophysiology and treatments of movement disorders.

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Section: Literature Searchmentioning

confidence: 99%

Antiseizure Drugs and Movement Disorders

Sáenz‐Farret

Tijssen

Eliashiv³

et al. 2022

CNS Drugs

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“…Um dos sintomas clássicos da atrofia do cerebelo é a ataxia, descrita como uma das principais lesões irreversíveis que afetam a coordenação motora, sendo caracterizada pela realização de movimentos incertos, inseguros e descoordenados, imprecisão em alcançar uma posição da extremidade final e oscilações durante o curso do movimento, afetando diretamente a realização da marcha, (Ferner, 2022;Calsani, 2007;Rissardo & Caprara 2022). Com isto, o quadro motor do paciente se torna debilitado, pois a marcha é um fator essencial para a qualidade de vida dos indivíduos (Guirao-Bringas, & Díaz-Pérez, 2012).…”

Section: Resultsunclassified

Relato de caso: Atrofia cerebelar associada à intoxicação por Fenitoína em um munícipio da região amazônica

Araújo¹,

Simonetto²,

Souza³

et al. 2023

RSD

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A ataxia cerebelar, é um dos sintomas clássicos da atrofia cerebelar, considerada também uma das principais lesões que afetam a coordenação motora, sendo de caráter irreversível interferindo na realização dos movimentos sendo estes incertos, inseguros, descoordenados e imprecisos, debilitando assim o quadro motor do paciente. Essa lesão cerebelar pode ser ocasionada a partir de doses elevadas associadas ao uso crônico da Fenitoína, um medicamento que pertence à classe das hidantoínas, um bloqueador dos canais de sódio, metabolizado pelo CYP2C9/10 hepático, é um dos antiepilépticos de primeira escolha para o tratamento/controle da epilepsia. Este relato destaca o caso de uma paciente que apresentou dificuldade na realização da marcha e consequentemente piora na coordenação motora, hiperplasia gengival e hirsutismo. Após investigação através de exames laboratorial e de imagem, foi confirmada a intoxicação por Fenitoína devido ao seu uso crônico e a atrofia do cerebelo desenvolvendo ataxia da marcha.

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“…All participants in our cohort are right-handed ( 31 , 36 ). Exclusion criteria included: (1) Those who had a psychiatric or neurological disorder other than MTLE, (2) Those who had a cerebral or cerebellar lesion other than HS, (3) Those who were below 16 or over 65 years of age, (4) Those who were unable to endure or comprehend the procedure, (5) Those who had poor imaging quality, including excessive head motion or poor task effect, and (6) Those who received phenytoin treatment ( 37 ).…”

Section: Methodsmentioning

confidence: 99%

Cerebellar functional disruption and compensation in mesial temporal lobe epilepsy

et al. 2023

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BackgroundCerebellar functional alterations are common in patients with mesial temporal lobe epilepsy (MTLE), which contribute to cognitive decline. This study aimed to deepen our knowledge of cerebellar functional alterations in patients with MTLE.MethodsIn this study, participants were recruited from an ongoing prospective cohort of 13 patients with left TLE (LTLE), 17 patients with right TLE (RTLE), and 30 healthy controls (HCs). Functional magnetic resonance imaging data were collected during a Chinese verbal fluency task. Group independent component (IC) analysis (group ICA) was applied to segment the cerebellum into six functionally separated networks. Functional connectivity was compared among cerebellar networks, cerebellar activation maps, and the centrality parameters of cerebellar regions. For cerebellar functional profiles with significant differences, we calculated their correlation with clinical features and neuropsychological scores.ResultCompared to HCs and patients with LTLE, patients with RTLE had higher cerebellar functional connectivity between the default mode network (DMN) and the oculomotor network and lower cerebellar functional connectivity from the frontoparietal network (FPN) to the dorsal attention network (DAN) (p < 0.05, false discovery rate- (FDR-) corrected). Cerebellar degree centrality (DC) of the right lobule III was significantly higher in patients with LTLE compared to HC and patients with RTLE (p < 0.05, FDR-corrected). Higher cerebellar functional connectivity between the DMN and the oculomotor network, as well as lower cerebellar degree centrality of the right lobule III, was correlated with worse information test performance.ConclusionCerebellar functional profiles were altered in MTLE and correlated with long-term memory in patients.

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Phenytoin and damage to the cerebellum – a systematic review of published cases

Cited by 7 publications

References 24 publications

Antiseizure Drugs and Movement Disorders

Antiseizure Drugs and Movement Disorders

Relato de caso: Atrofia cerebelar associada à intoxicação por Fenitoína em um munícipio da região amazônica

Cerebellar functional disruption and compensation in mesial temporal lobe epilepsy

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