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Reflex sympathetic dystrophy associated with antiepileptic drugs
G F Falasca1, T M Toly, A J Reginato
1Division of Rheumatology, Cooper Hospital/University Medical Center, UMDNJ-Robert Wood Johnson Medical School at Camden.
Epilepsia
|March 1, 1994
Summary
Antiepileptic drug therapy can complicate with reflex sympathetic dystrophy syndrome (RSDS), a condition not widely recognized. Early recognition and treatment with prednisone are crucial to prevent permanent disability from this adverse drug reaction.
Area of Science:
- Neurology
- Pharmacology
Background:
- Reflex sympathetic dystrophy syndrome (RSDS) is a poorly acknowledged complication of antiepileptic drug (AED) therapy in neurologic literature.
- AEDs are commonly prescribed for epilepsy and other neurologic conditions.
Observation:
- Four patients developed RSDS while undergoing AED treatment.
- Affected patients presented with shoulder and hand involvement, sometimes bilateral, and one had ipsilateral foot involvement.
- Two patients did not improve after changing AEDs.
Findings:
- All patients with AED-associated RSDS improved with prednisone treatment.
- One patient experienced a relapse of phenobarbital-associated RSDS upon inadvertent rechallenge with secobarbital.
- Literature review indicates AEDs are associated with other fibrosing disorders like Dupuytren's contractures and frozen shoulder.
Implications:
- AED-associated RSDS requires prompt recognition and management to prevent long-term disability.
- Clinicians should consider RSDS in patients on AEDs presenting with characteristic symptoms.
- Further research into the mechanisms and management of AED-induced fibrosing conditions is warranted.