Abstract | INTRODUCTION: The antiseizure medication phenytoin has been associated with changes in the cerebellum, cerebellar signs, and permanent cerebellar damage. We have systematically reviewed the clinical and radiological features, and their correlation. AREAS COVERED: We identified sixty case reports and case series of the effects of phenytoin on the cerebellum by searching Medline and Embase and relevant reference lists. The reports described 92 [median 1, range 1-5] cases, documented median age 28 [2.7-78] years. Eighty-one cases described one or more clinical sign of ataxia (present in 96%), dysarthria (63%), and nystagmus (70%). The neurological outcome (in 76 cases): 10 (13%) recovered by 12 months; 55 (72%) suffered residual disability; and 11 (14%) died. Median serum phenytoin concentration (48 cases) was 50 (interquartile range 31-66) mg/L; only three values were below 20 mg/L. The radiological findings included cerebellar atrophy in 41 of 61 patients (67%) with at least one scan. EXPERT OPINION:
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Authors | Robin Ferner, Rachael Day, Sally M Bradberry |
Journal | Expert opinion on drug safety
(Expert Opin Drug Saf)
Vol. 21
Issue 7
Pg. 957-977
(Jul 2022)
ISSN: 1744-764X [Electronic] England |
PMID | 35325581
(Publication Type: Journal Article, Systematic Review)
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Chemical References |
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Topics |
- Adult
- Ataxia
(chemically induced, drug therapy, pathology)
- Atrophy
(drug therapy, pathology)
- Cerebellar Ataxia
(chemically induced, drug therapy, pathology)
- Cerebellar Diseases
(chemically induced, diagnostic imaging, drug therapy)
- Cerebellum
(diagnostic imaging, pathology)
- Humans
- Phenytoin
(adverse effects)
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