Transient Anterior Horn Cell Dysfunction in Diphenylhydantoin Therapy

Abstract

A report on a patient who developed profuse fasciculations following diphenylhydantoin therapy for 30 months with subsequent complete recovery on cessation of therapy is presented. In view of the considerable variability of spontaneous potentials generated in spinal motor neurones, in vitro studies and pathological states with respect to shape, amplitude, frequency and duration, caution is advised in the assessment of the clinical significance of fasciculations. The possibility that our patient represents an instance of a ‘reversible form of motor neuron disease’ is entertained.

Chronic Anticonvulsive Therapy, Peripheral Nerve Conduction Velocity, and EMG

“…In single cases reported by Boschi and Menozzi (1965) and Meienberg and Bajc (1975) acute, toxic DHT-induced nerve conduction impairment was accompanied by EMG signs of active denervation (posi-tive sharp waves and fibrillation potentials). Direkze and Fernando (1977) reported a single case which showed fasciculation activity caused by DHT treatment, but nerve conduction studies were normal. The case reported by Dobkin (1977) had acute nerve conduction slowing with DHT intoxication, but EMG signs of active denervation were not detected.…”