Abstract
Background: Dyskinetic neurological diseases are common presentations of adverse reaction to many therapeutic agents. Phenytoin, a widely used age-old antiepileptic drug has been reported to cause dyskinesias, a rare Adverse Drug Reaction (ADR) in adults with toxic therapeutic serum level. When the drug is used in combination with other drugs which augments free drug level of phenytoin or in patients of organic brain lesion, this side effect is very occasionally reported with even normal therapeutic drug level.
Clinical Case: We report a case of young male presented with chorea after two months of starting phenytoin for primary generalised epilepsy with normal therapeutic serum drug level. After excluding other differentials, drug-induced chorea was the final diagnosis. Despite phenytoin level was in therapeutic range, we have a trial of stopping Phenytoin with complete disappearance of chorea in 3 days. On reintroduction of phenytoin in the same dose, there was the reappearance of chorea in onemonth re-emphasising the diagnosis as “phenytoin-induced chorea”.
Conclusion: If any patient on phenytoin develops any new neurological feature including dyskinesias, it should be considered as an ADR despite drug serum level within the normal therapeutic range.
Keywords: Adverse drug reaction, chorea, phenytoin, antiepileptic drugs, MRI, dyskinesias.
Graphical Abstract
Related Journals
Anti-Cancer Agents in Medicinal Chemistry
Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry
Current Bioactive Compounds
Current Drug Targets
Current Neuropharmacology
Current Pharmaceutical Design
Current Pharmaceutical Analysis
Current Vascular Pharmacology
Letters in Drug Design & Discovery
Current Drug Discovery Technologies
Related Books
Frontiers in Drug Design and Discovery
New Findings from Natural Substances
Key Heterocyclic Cores for Smart Anticancer Drug–Design Part II
Key Heterocyclic Cores for Smart Anticancer Drug–Design Part I
Pharmaceutical Chemistry and Production: An Introductory Textbook
Evidence-Based Research in Ayurveda against COVID-19 in Compliance with Standardized Protocols and Practices
Pharmaceuticals for Targeting Coronaviruses
Frontiers in Cardiovascular Drug Discovery
Frontiers in Drug Design and Discovery
Medical Applications of Beta-Glucan
34
2
1
1