Lindvall O, Nilsson B
Ann Neurol. 1984 Aug;16(2):258-60. doi: 10.1002/ana.410160218.
Cerebellar degeneration has been demonstrated in several patients receiving phenytoin therapy. In most cases it has been unclear, however, whether the degeneration was caused by the drug per se or by other mechanisms known to lead to cerebellar damage. We describe a patient who developed a marked cerebellar atrophy, demonstrated on computed tomographic scan, following an episode of acute, severe phenytoin intoxication. The patient received phenytoin prophylactically for 2 1/2 months after an uncomplicated subarachnoid hemorrhage and was in good health when the treatment was started. He has never had seizures, and no other possible cause of chronic cerebellar changes is known. The initially severe clinical signs of cerebellar dysfunction have subsided slowly. We conclude that phenytoin can directly cause cerebellar degeneration.
在接受苯妥英治疗的数名患者中已证实存在小脑变性。然而，在大多数情况下，尚不清楚这种变性是由药物本身引起的，还是由其他已知会导致小脑损伤的机制引起的。我们描述了一名患者，在一次急性、严重的苯妥英中毒发作后，计算机断层扫描显示出现了明显的小脑萎缩。该患者在无并发症的蛛网膜下腔出血后预防性服用苯妥英2个半月，开始治疗时身体健康。他从未发生过癫痫发作，也不存在其他可能导致慢性小脑改变的原因。最初严重的小脑功能障碍临床体征已缓慢消退。我们得出结论，苯妥英可直接导致小脑变性。
