title: Dendritic, axonal, and spinal pathology of the Purkinje cells and the neurons of the dentate nucleus after long-term phenytoin administration: a case report.
abstract: Phenytoin is a commonly prescribed anticonvulsant drug; however, there is evidence that long-term administration is related to cerebellar ataxia, cerebellar atrophy, loss of Purkinje cells, and hyperplasia of Bergman glia cells. The aim of the present study was to detect and describe any possible alterations of the Purkinje cells, and neurons of the dentate nucleus, as those can be seen with the use of silver impregnation techniques, such as Golgi and Nauta method. The study was performed on a 7-year-old boy who was under phenytoin treatment for more than 3.5 years and had clinical manifestations of cerebellar ataxia. Golgi silver impregnation technique revealed substantial loss of dendritic spines and tertiary dendritic branches, both on the Purkinje cells and the neurons of the dentate nucleus, whereas the Nauta method demonstrated swollen and degenerated axons of Purkinje cells.
authors.affiliation: 1Department of Neurology, Laboratory of Neuropathology and Electron Microscopy, Aristotle University of Thessaloniki, Greece.
authors.forename: Ioannis A
authors.initials: IA
authors.lastname: Mavroudis
authors.forename: Marina G
authors.initials: MG
authors.lastname: Manani
authors.forename: Foivos
authors.initials: F
authors.lastname: Petrides
authors.forename: Matina
authors.initials: M
authors.lastname: Kiourexidou
authors.forename: Samuel Ndugu
authors.initials: SN
authors.lastname: Njau
authors.forename: Vasiliki G
authors.initials: VG
authors.lastname: Costa
authors.forename: Stavros J
authors.initials: SJ
authors.lastname: Baloyannis
mesh_terms: D000927:Anticonvulsants / Q000494:pharmacology / Q000627:therapeutic use*; D001369:Axons / Q000187:drug effects / Q000473:pathology; D002529:Cerebellar Nuclei / Q000187:drug effects* / Q000473:pathology; D002648:Child; D003712:Dendrites / Q000187:drug effects / Q000473:pathology; D049229:Dendritic Spines / Q000187:drug effects / Q000473:pathology; D004830:Epilepsy, Tonic-Clonic / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008297:Male; D010672:Phenytoin / Q000494:pharmacology / Q000627:therapeutic use*; D011689:Purkinje Cells / Q000187:drug effects* / Q000473:pathology
chemical_list: D000927:Anticonvulsants; D010672:Phenytoin