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Phenytoin toxicity: an easily missed cause of cerebellar syndrome
Author(s) -
Brostoff J. M.,
Birns J.,
McCrea D.
Publication year - 2008
Publication title -
journal of clinical pharmacy and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.622
H-Index - 73
eISSN - 1365-2710
pISSN - 0269-4727
DOI - 10.1111/j.1365-2710.2008.00903.x
Subject(s) - phenytoin , toxicity , medicine , epilepsy , pharmacokinetics , nice , drug toxicity , drug , anticonvulsant , pharmacology , first line , anesthesia , computer science , psychiatry , programming language
Summary We present a series of cases of phenytoin toxicity where the diagnosis was initially missed. These patients all suffered unnecessary morbidity or investigations. The side‐effects and unusual pharmacokinetics of phenytoin are discussed, as well as the array of potential drug interactions. We remind clinicians that phenytoin toxicity can easily mimic a cerebellar lesion or alcohol intoxication, and suggest that in accordance with National Institute for Clinical Excellence (NICE) guidelines phenytoin should no longer be used as a first‐line treatment for epilepsy.