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Phenytoin intoxication.

J M Murphy1, R Motiwala, O Devinsky

  • 1Department of Neurosciences, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark.

Southern Medical Journal
|October 1, 1991
PubMed
Summary
This summary is machine-generated.

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This study on phenytoin toxicity found that iatrogenic causes are common. Most patients experienced neurological symptoms like nystagmus and ataxia, but outcomes were generally favorable.

Area of Science:

  • Pharmacology
  • Clinical Neurology
  • Toxicology

Background:

  • Phenytoin is a widely used antiepileptic drug.
  • Monitoring serum phenytoin levels is crucial for therapeutic efficacy and safety.
  • Understanding the clinical manifestations of phenytoin toxicity is essential for timely diagnosis and management.

Observation:

  • A study of 85 cases of phenytoin toxicity in 76 patients was conducted.
  • Serum phenytoin levels on admission ranged from 30.3 to 95.0 µg/mL (median, 46.5 µg/mL).
  • Iatrogenic causes, including dosage increases and IV loading for seizures in patients with subtherapeutic levels, were frequent.

Findings:

  • The most common neurological findings were nystagmus (95%) and ataxia (88%).
  • Lethargy (22%) and seizures (19%) were also observed.

Related Experiment Videos

  • While most outcomes were favorable, three patients experienced serious complications.

    • Implications:

    • This highlights the importance of careful dosing and monitoring of phenytoin to prevent toxicity.
    • Clinicians should be aware of the common neurological signs associated with phenytoin intoxication.
    • Further strategies may be needed to mitigate iatrogenic phenytoin toxicity in clinical practice.