Imaging in phenytoin induced neurotoxicity: a case series

Authors

  • Manali Arora Department of Radiology, Pramukhswami Medical College, Anand, Gujarat, India
  • Deb Kumar Boruah Department of Radiology, Assam Medical College, Dibrugarh, Assam, India
  • Vishal Thakker Department of Radiology, Pramukhswami Medical College, Anand, Gujarat, India
  • Sangeeta Bhanwra Department of Pharmacology, Government Medical College, Chandigarh, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20175749

Keywords:

Anti-epileptic drugs, Cerebellar Degeneration, Epilepsy

Abstract

Phenytoin is a commonly used anti-epileptic drug for various types of seizure disorders except for absent seizures. Long term dose dependant neurological side effects of phenytoin therapy include cerebellar atrophy, cerebral atrophy and brain stem atrophy. Skull hyperostosis, gum hypertrophy and megaloblastic anemia are other known effects of Long term therapy. We present four cases depicting clinical and neuroimaging findings of Phenytoin induced Toxicity.

References

Gupta M, Patidar Y, Khwaja GA, Chowdhury D, Batra A, Dasgupta A. Persistent cerebellar ataxia with cerebellar cognitive affective syndrome due to acute phenytoin intoxication: A case report. Neurol Asia. 2013;18(1):107-1.

De Marco FA, Ghizoni E, Kobayashi E, Li LM, Cendes F. Cerebellar volume and long-term use of phenytoin. Seizure. 2003;12(5):312-5.

Tamrazi B, Almast J. Your brain on drugs: imaging of drug-related changes in the central nervous system. Radiographics. 2012;32(3):701-19.

Del Negro AN, Dantas CD, Zanardi VE, Montenegro MA, Cendes FE. Dose-dependent relationship of chronic use of phenytoin and cerebellar atrophy in patients with epilepsy. Arquivos de neuro-psiquiatria. 2000.

Matsusue E, Fujii S, Kanasaki Y, Kaminou T, Ohama E, Ogawa T. Cerebellar Lesions in Multiple System Atrophy: Postmortem MR Imaging- Pathologic Correlations. Americ J Neuroradiol. 2009;30(9):1725-30.

Poretti A, Wolf NI, Boltshauser E. Differential diagnosis of cerebellar atrophy in childhood. Eur J Paediatr Neurol. 2008;12(3):155-67.

Chow KM, Szeto CC. Cerebral atrophy and skull thickening due to chronic phenytoin therapy. Canadian Medical Association J. 2007;176(3):321-3.

Menon VB, Kurian J, Undela K, Ramesh M, Gowdappa HB. Phenytoin toxicity: A case report. J Young Pharmac. 2015;7(3):272.

Corrêa JD, Queiroz-Junior CM, Costa JE, Teixeira AL, Silva TA. Phenytoin-induced gingival overgrowth: a review of the molecular, immune, and inflammatory features. ISRN dentistry. 2011:25;2011.

Lowenstein DH. Seizures and epilepsy. Harrison’s principles of internal medicine. 2016;19(2):2254.

Downloads

Published

2017-12-23

How to Cite

Arora, M., Kumar Boruah, D., Thakker, V., & Bhanwra, S. (2017). Imaging in phenytoin induced neurotoxicity: a case series. International Journal of Research in Medical Sciences, 6(1), 355–358. https://doi.org/10.18203/2320-6012.ijrms20175749

Issue

Section

Case Reports