Hemiballism in a patient with partial motor status epilepticus treated with phenytoin.
A 13-year-old girl developed left partial motor status epilepticus with severe postictal hemiparesis. Magnetic resonance imaging showed a right frontoparietal hyperintense T2 weighted signal. Treated with phenytoin, carbamazepine and phenobarbital, seizures subsided but left choreic-like flinging movements, consistent with hemiballism, presented 2 days later. On phenytoin withdrawal, symptoms gradually remitted with mild residual dystonia at 14 months follow-up. It is speculated that the lesion might have rendered the cortex more susceptible to phenytoin, inducing unilateral toxicity.
Micheli
F
F
Department of Neurology, Jose de San Martin University Hospital, Buenos Aires, Argentina.
Lehkuniec
E
E
Gatto
M
M
Pelli
M
M
Asconape
J
J
D000293:Adolescent; D001480:Basal Ganglia Diseases / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D001921:Brain / Q000000981:diagnostic imaging; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009069:Movement Disorders / Q000150:complications; D010672:Phenytoin / Q000008:administration & dosage / Q000627:therapeutic use*; D011859:Radiography
D010672:Phenytoin