Phenytoin-induced visual disturbances mimicking Delirium Tremens in a child

Marín, Laura López; Garcı́a-Peñas, Juan José; Herguedas, Julian Lara; Gutiérrez-Solana, Luis González; Ruiz-Falcó, MariLuz; Duat-Rodríguez, Anna; Extremera, Verónica Cantarín

doi:10.1016/j.ejpn.2010.05.008

Cited by 10 publications

(7 citation statements)

References 15 publications

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“…[5][6][7]9,10 Previous studies reported that AEDs, especially phenytoin, might cause severe cooperation difficulties, somnolence, delirium, acute visual dysfunction, acute meningoencephalitis, confusion, lethargy, and coma. 13,17,24,26,28,49 Thus, we may conclude that trying to avoid phenytoin loading during surgery may be of benefit. If required, it may be advised that loading the patient with phenytoin will take place 1 or 2 days prior to surgery, while monitoring blood levels and adjusting drug doses accordingly.…”

Section: Causes Of Awake Craniotomy Failuresmentioning

confidence: 99%

Failed awake craniotomy: a retrospective analysis in 424 patients undergoing craniotomy for brain tumor

Nossek¹,

Matot

Shahar³

et al. 2013

JNS

157

136

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Section: Causes Of Awake Craniotomy Failuresmentioning

confidence: 99%

Failed awake craniotomy: a retrospective analysis in 424 patients undergoing craniotomy for brain tumor

Nossek¹,

Matot

Shahar³

et al. 2013

JNS

157

136

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“…In addition to these effects, Aman and colleagues have found minimal effects of phenytoin on psychomotor performance [132]. In rare instances, phenytoin exposure has also been associated with psychosis, delirium [133], and transient effects on visual functioning [134]. …”

Section: Exposure Of Children To Aeds In Early Postnatal Lifementioning

confidence: 99%

Impact of early life exposure to antiepileptic drugs on neurobehavioral outcomes based on laboratory animal and clinical research

Bath

Scharfman

2013

Epilepsy & Behavior

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Epilepsy affects approximately 1% of children under the age of 15, making it a very common neurological disorder in the pediatric population (Russ et al., 2012 [1]). In addition, ∼0.4–0.8% of all pregnant women have some form of epilepsy (Hauser et al., 1996a,b; Borthen et al., 2009; Krishnamurthy, 2012 [2–5]). Despite the potential deleterious effects of antiepileptic drugs (AEDs) on the developing brain, their use is still required for seizure control in pregnant women (Krishnamurthy, 2012 [5]), and they represent the standard approach for treating children with epilepsy (Chu-Shore and Thiele, 2010; Quach et al., 2010; Verrotti et al., 2011 [6–8]). Even when AEDs are effective, there are potential side effects, including cognitive and affective changes or altered sleep and appetite. The consequences of AED exposure in development have been studied extensively (Canger et al., 1999; Modi et al., 2011a,b; Oguni, 2011 [9–12]). Despite intensive study, there is still debate about the long-term consequences of early life AED exposure. Here, we consider the evidence to date that AED exposure, either prenatally or in early postnatal life, has significant adverse effects on the developing brain and incorporate studies of laboratory animals as well as those of patients. We also note the areas of research where greater clarity seems critical in order to make significant advances. A greater understanding of the impact of AEDs on somatic, cognitive and behavioral development has substantial value because it has the potential to inform clinical practice and guide studies aimed at understanding the genetic and molecular bases of comorbid pathologies associated with common treatment regimens. Understanding these effects has the potential to lead to AEDs with fewer side effects. Such advances would expand treatment options, diminish the risk associated with AED exposure in susceptible populations, and improve the quality of life and health outcomes of children with epilepsy and children born to women who took AEDs during pregnancy.

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“…Phenytoin is a state‐dependent sodium channel blocker with a small preference (~10%) for persistent current over peak current . However, high‐dose phenytoin has significant safety concerns due to saturable metabolism and risk for phenytoin poisoning . GS‐458967 (GS967) is a novel sodium channel modulator specifically developed to inhibit persistent sodium current, with a 42‐fold preference for persistent as opposed to peak current inhibition .…”

Section: Introductionmentioning

confidence: 99%

“…17 However, high-dose phenytoin has significant safety concerns due to saturable metabolism and risk for phenytoin poisoning. [18][19][20][21] GS-458967 (GS967) is a novel sodium channel modulator specifically developed to inhibit persistent sodium current, with a 42-fold preference for persistent as opposed to peak current inhibition. 22 Our previous studies demonstrated that acute application of GS967 to hippocampal neurons did not affect the current-voltage relationship or voltage dependence of activation, but induced a hyperpolarized shift of steady-state channel inactivation and slowed both recovery from fast inactivation and onset of slow inactivation.…”

Section: Introductionmentioning

confidence: 99%

The novel sodium channel modulator GS‐458967 (GS967) is an effective treatment in a mouse model of SCN8A encephalopathy

Thompson

Hawkins

et al. 2018

Epilepsia

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Phenytoin-induced visual disturbances mimicking Delirium Tremens in a child

Cited by 10 publications

References 15 publications

Failed awake craniotomy: a retrospective analysis in 424 patients undergoing craniotomy for brain tumor

Failed awake craniotomy: a retrospective analysis in 424 patients undergoing craniotomy for brain tumor

Impact of early life exposure to antiepileptic drugs on neurobehavioral outcomes based on laboratory animal and clinical research

The novel sodium channel modulator GS‐458967 (GS967) is an effective treatment in a mouse model of SCN8A encephalopathy

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