Montenegro M A, Scotoni A E, Cendes F
Departamento de Neurologia, Faculdade de Ciências Médicas (FCM) da Universidade Estadual de Campinas (UNICAMP), Brasil.
Arq Neuropsiquiatr. 1999 Jun;57(2B):356-60. doi: 10.1590/s0004-282x1999000300002.
Phenytoin is an effective antiepileptic drug, although, it can be associated with many side effects, including dyskinesia.
To describe the clinical characteristics of phenytoin induced dyskinesia.
We investigated the occurrence of involuntary movements in patients followed at our adult and pediatric epilepsy clinics during the period of one year.
Three patients presented with phenytoin-induced dyskinesia: one adult with axial and orofacial dyskinesia, and two children with choreoathetosis. They did not have other signs of phenytoin intoxication and had complete recovery after phenytoin withdrawal.
Phenytoin induced dyskinesia may occur during either chronic or initial treatment and with normal serum phenytoin levels. However, it occurs most often in patients on polytherapy, usually after increasing dosage and with toxic serum levels. Other signs of phenytoin intoxication may be present in these patients, but often the dyskinesia is the only side effect, which may delay the diagnosis and treatment. The clinical characteristics of the involuntary movements vary and may be focal or generalized, most often characterized by choreoathetosis and dyskinesias. These may last for hours, days or even years, but frequently disappear completely after phenytoin withdrawal.
苯妥英是一种有效的抗癫痫药物，尽管它可能与许多副作用相关，包括运动障碍。
描述苯妥英诱导的运动障碍的临床特征。
我们调查了在我们的成人和儿科癫痫门诊随访一年期间患者中不自主运动的发生情况。
三名患者出现苯妥英诱导的运动障碍：一名成人患有轴性和口面部运动障碍，两名儿童患有舞蹈手足徐动症。他们没有苯妥英中毒的其他体征，停用苯妥英后完全康复。
苯妥英诱导的运动障碍可能在慢性或初始治疗期间出现，且血清苯妥英水平正常时也可能发生。然而，它最常发生在接受联合治疗的患者中，通常在增加剂量且血清水平有毒时出现。这些患者可能存在苯妥英中毒的其他体征，但通常运动障碍是唯一的副作用，这可能会延迟诊断和治疗。不自主运动的临床特征各不相同，可能是局灶性或全身性的，最常见的特征是舞蹈手足徐动症和运动障碍。这些症状可能持续数小时、数天甚至数年，但通常在停用苯妥英后完全消失。
