title: Phenytoin toxicity: an easily missed cause of cerebellar syndrome.
abstract: We present a series of cases of phenytoin toxicity where the diagnosis was initially missed. These patients all suffered unnecessary morbidity or investigations. The side-effects and unusual pharmacokinetics of phenytoin are discussed, as well as the array of potential drug interactions. We remind clinicians that phenytoin toxicity can easily mimic a cerebellar lesion or alcohol intoxication, and suggest that in accordance with National Institute for Clinical Excellence (NICE) guidelines phenytoin should no longer be used as a first-line treatment for epilepsy.
authors.affiliation: Department of Elderly Care, Central Middlesex Hospital, London, UK. joshbrostoff@doctors.org.uk
authors.forename: J M
authors.initials: JM
authors.lastname: Brostoff
authors.forename: J
authors.initials: J
authors.lastname: Birns
authors.forename: D
authors.initials: D
authors.lastname: McCrea
mesh_terms: D000368:Aged; D000927:Anticonvulsants / Q000009:adverse effects* / Q000097:blood / Q000493:pharmacokinetics; D002526:Cerebellar Diseases / Q000139:chemically induced* / Q000175:diagnosis; D004827:Epilepsy / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010672:Phenytoin / Q000009:adverse effects* / Q000097:blood / Q000493:pharmacokinetics
chemical_list: D000927:Anticonvulsants; D010672:Phenytoin