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苯妥英钠诱导的运动障碍:一例报告。

Phenytoin-induced dyskinesia: a case report.

机构信息

L. M. College of Pharmacy, Ahmedabad, Gujarat, 380009, India.

GCS Medical College, Hospital and Research Centre, Ahmedabad, Gujarat, 380025, India.

出版信息

J Med Case Rep. 2023 Jul 21;17(1):313. doi: 10.1186/s13256-023-04033-6.

Abstract

BACKGROUND

Dyskinesia is a movement disorder categorized by involuntary movement of muscle. Although dyskinesia can be brought on by taking medications, it can also be a symptom of a variety of diseases. Antiepileptic drug-induced involuntary movements have been well researched. Rare reports have been made for dyskinesia, a type of dystonia caused by phenytoin. The mechanism of its occurrence must be succinctly studied.

CASE PRESENTATION

A 53-year-old Asian patient taking phenytoin (100 mg twice daily) experienced symptoms of perioral muscle involuntary movement, impaired speech, and generalized tremors and was admitted to the hospital. Brain magnetic resonance imaging showed significant development of encephalomalacia and porencephaly. The serum phenytoin levels were in the toxic range (33 g/ml). These were suggestive of phenytoin-induced dyskinesia. Levetiracetam and clonazepam were initiated, and the patient showed significant improvement in the symptoms.

CONCLUSION

This case presented a substantial reference value for the differential diagnosis and treatment prognosis of phenytoin-induced dyskinesia. The phenytoin-induced dyskinesia in this patient was successfully reversed with prompt identification and treatment. According to the case study's findings, such people may benefit from periodic therapeutic drug monitoring.

摘要

背景

运动障碍是一种由肌肉不自主运动引起的疾病。虽然运动障碍可能是由于服用药物引起的,但它也可能是多种疾病的症状。抗癫痫药物引起的不自主运动已经得到了充分的研究。关于苯妥英钠引起的运动障碍(一种肌张力障碍)的罕见报告已经发表。其发生机制必须进行简洁的研究。

病例介绍

一位 53 岁的亚洲患者正在服用苯妥英钠(每日两次,每次 100 毫克),出现口周肌肉不自主运动、言语障碍、全身震颤等症状,随后被收治入院。脑磁共振成像显示明显的脑软化和脑穿通畸形。血清苯妥英钠水平处于中毒范围(33μg/ml)。这些都提示苯妥英钠引起的运动障碍。随后开始使用左乙拉西坦和氯硝西泮,患者的症状显著改善。

结论

本病例为苯妥英钠引起的运动障碍的鉴别诊断和治疗预后提供了重要参考价值。该患者的苯妥英钠诱导的运动障碍通过及时识别和治疗得到了成功逆转。根据病例研究结果,此类患者可能受益于定期进行治疗药物监测。

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