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Dilantin-induced long-term bilateral total external ophthalmoplegia
Journal of Clinical Neuro-Ophthalmology
|March 1, 1986
Summary
A rare case of total ophthalmoplegia occurred after brain surgery due to toxic Dilantin levels. This eye movement disorder, unlike previous reports, took three months to resolve, highlighting a prolonged recovery from Dilantin toxicity.
Area of Science:
- Neurology
- Ophthalmology
- Pharmacology
Background:
- Corpus callosum arteriovenous malformations (AVMs) require surgical intervention.
- Postoperative complications can include neurological deficits and anesthetic-related issues.
Observation:
- A young woman developed total external ophthalmoplegia after AVM resection surgery.
- Her oculomotor impairment persisted despite rapid mental status improvement.
Findings:
- Cerebrovascular and anesthetic complications were ruled out.
- Postoperative toxic levels of Dilantin (phenytoin) were identified as the cause of ophthalmoplegia.
- Unlike typical cases, this ophthalmoplegia showed prolonged resolution over 3 months.
Implications:
- This case expands the known spectrum of Dilantin-induced neurotoxicity.
- It underscores the importance of monitoring Dilantin levels in patients with unexplained oculomotor deficits.
- Highlights the potential for delayed recovery from drug-induced ophthalmoplegia.