Article type: Literature Review
Article
title: Phenytoin-associated
movement disorder: A literature review
Journal: Tzu
Chi Medical Journal
Year: 2022
Authors: Jamir Pitton Rissardo, Ana Letícia Fornari Caprara
E-mail:
jamirrissardo@gmail.com
ABSTRACT
Phenytoin (PHT) was first synthesized as a barbiturate
derivative and was approved in 1953 by the Food and Drug Administration. This
work aimed to review the pathophysiology, epidemiology, clinical presentation,
and treatment of PHT-associated movement disorders (MDs). Studies were searched
in relevant databases (ScienceDirect, Google Scholar, Excerpta Medica, Latin
American and Caribbean Health Sciences Literature, Medline, and Scientific
Electronic Library Online) and were selected by two reviewers irrespective of
language between 1963 and 2021. Papers of PHT-induced ataxia alone or tremor
were excluded. In total, 127 reports with 219 individuals who developed MDs
associated with PHT were encountered. MDs found: 126 dyskinesias, 49 myoclonus,
19 dystonia, 14 parkinsonism, 6 tics, 3 stuttering, and 2 restless legs
syndrome. The mean age was 35 years (standard deviation [SD]: 23.5) and the
predominant sex was male (53.4%). The mean PHT dose when the MD took place was
370.4 mg (SD: 117.5). A serum PHT concentration was reported in 103 cases,
ranging from 4 to 110 μg/mL (median: 27.7 μg/mL). No significant relationship
was found between PHT dose and age or PHT level. The mean onset time of
PHT-associated MD was 23.4 months (SD: 4.4). The mean recovery time after MD
management was 3.7 weeks (SD: 1.1). Regarding management, the most common form
was PHT withdrawal in 90.4%. 86.3% of the individuals recovered fully.
PHT-induced MD was extensively reported in the literature. Only general terms
were used in the majority of the reports. The mechanisms underlying the adverse
events caused by PHT probably depend on the presence of predisposing factors.
Keywords: Dilantin, Drug-induced, Movement
Disorder, Phenytoin, Review.
Full text available at:
https://www.tcmjmed.com/text.asp?2022/34/4/409/357756
DOI
10.4103/tcmj.tcmj_74_22
Citation
Rissardo JP, Caprara AL.
Phenytoin-associated movement disorder: A literature review. Tzu Chi Med J 2022;34:409-17
