PHENYTOIN TOXICITY PRESENTING AS PARADOXICAL SEIZURES
Dr. Sandhya Manorenj* and Dr. Snehalatha Inturi
ABSTRACT
Phenytoin is a commonly used antiepileptic drug in developing countries like India. It is widely used against generalised tonic-clonic and complex partial seizures. Phenytoin is reported to cause a range of deleterious and erratic side effects even at therapeutic doses. We have come to recognize a clinical syndrome “paradoxical intoxication.” This we define as the situation in which seizure frequency increases as the blood level of that anticonvulsant rises. This high drug level is accompanied by few or no toxic signs, hence the paradox. This case report highlights the adverse drug reactions of phenytoin at therapeutic doses and the need of regular monitoring in patients on long-term therapy. We also stress the need to recognize toxicity of antiepileptic drugs at presentation to arrive at an early diagnosis.
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