Reflex sympathetic dystrophy associated with antiepileptic drugs.
Reflex sympathetic dystrophy syndrome (RSDS) complicating antiepileptic drug (AED) therapy is not well acknowledged in the neurologic literature. We report 4 patients with reflex sympathetic dystrophy that occurred while they were receiving AEDs. All patients had shoulder and hand involvement, which in 2 was bilateral, and 1 had ipsilateral foot involvement. Two patients did not respond to a change in AEDs, but all improved with a course of prednisone. One patient with phenobarbital (PB)-associated RSDS relapsed on inadvertent rechallenge with secobarbital. A review of the literature showed that several other fibrosing disorders are associated with AED administration, including Dupuytren's contractures, frozen shoulder, plantar and hand nodules, and Peyronie's disease. RSD associated with AEDs is important to recognize because it may result in permanent disability if treatment is delayed.
Falasca
G F
GF
Division of Rheumatology, Cooper Hospital/University Medical Center, UMDNJ-Robert Wood Johnson Medical School at Camden.
Toly
T M
TM
Reginato
A J
AJ
Schraeder
P L
PL
O'Connor
C R
CR
D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000009:adverse effects*; D004387:Dupuytren Contracture / Q000139:chemically induced; D004827:Epilepsy / Q000188:drug therapy; D005260:Female; D006429:Hemiplegia / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy; D010411:Penile Induration / Q000139:chemically induced; D010634:Phenobarbital / Q000009:adverse effects; D011241:Prednisone / Q000627:therapeutic use; D012019:Reflex Sympathetic Dystrophy / Q000139:chemically induced* / Q000188:drug therapy
D000927:Anticonvulsants; D011241:Prednisone; D010634:Phenobarbital