[Temporal cerebellar atrophy following phenytoin therapy].

Epilepsy is considered among the causes of acquired cerebellar degeneration. It is broadly discussed if its real cause would be seizures, the cerebral hypoxia related to them, or different drugs used in epilepsy treatment, such as phenytoin or carbamazepine. We report on a young male diagnosed of partial seizures and treated with carbamazepine, who began to receive phenytoin after the meningioma removing. He suffered then a progressive cerebellar degeneration according to CT and MR controls during a 18 months follow-up. Serum phenytoin levels were always normal and the patient never presented symptoms related to acute toxicity. We consider phenytoin is the main cause of the cerebellar atrophy noted in our patient; the short time in which it developed makes us think that there is an special susceptibility in cerebellum cells to phenytoin toxicity.