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Pseudotumour cerebri due to phenytoin in a child

Sabitha Sasidharan Pillai1, Arakkal Riyaz1,2, Chakkiyar Krishnan1

  • 1Department of Pediatrics, Government Medical College, Calicut, Kerala, India.

British Journal of Clinical Pharmacology
|March 14, 2022
PubMed

Insights

This case report highlights phenytoin-induced pseudotumour cerebri in a child. Prompt withdrawal of phenytoin resolved symptoms, emphasizing its importance in diagnosing drug-induced intracranial hypertension.

Area of Science:

  • Neurology
  • Pediatrics
  • Ophthalmology

Background:

  • Pseudotumour cerebri, or idiopathic intracranial hypertension, is characterized by elevated intracranial pressure without a clear cause.
  • Phenytoin is an anticonvulsant medication commonly used for seizure prophylaxis.

Observation:

  • A 9-year-old boy developed headache and diplopia after receiving phenytoin for seizure prophylaxis post-surgery for Langerhans cell histiocytosis.
  • Clinical examination revealed bilateral sixth nerve palsy, and cerebrospinal fluid pressure was elevated.

Findings:

  • Phenytoin administration was causally linked to the development of pseudotumour cerebri in this pediatric patient.
  • Discontinuation of phenytoin led to complete resolution of the patient's symptoms and neurological deficits.

Implications:

  • This case underscores the importance of considering drug-induced aetiologies, specifically phenytoin, in pediatric patients presenting with signs of intracranial hypertension.
  • Early recognition and withdrawal of the offending agent are crucial to prevent potential vision loss and other complications associated with prolonged elevated intracranial pressure.

Keywords:
childidiopathic intracranial hypertensionphenytoinpseudotumour cerebri

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