Document Detail

Phenytoin-induced seizures: a paradoxical effect at toxic concentrations in epileptic patients.
MedLine Citation:
PMID:  2924747     Owner:  NLM     Status:  MEDLINE    
We examined the incompletely defined convulsant action of phenytoin (PHT) at toxic concentrations in humans. A retrospective chart review (1979-1985) yielded 96 cases (90 patients), meeting both clinical and laboratory criteria for PHT intoxication. Seven patients, all with epilepsy, had one or more seizures while toxic. However, in only two patients (2.1%) with serum concentrations of 93.2 and 69.7 micrograms/ml was a causal relationship deemed highly probable. Seizures did not occur in most toxic epileptic patients with total serum PHT concentrations as high as 85.1 micrograms/ml or in any of the nonepileptic patients with concentrations as high as 64.2 micrograms/ml. The lack of convulsant action of PHT in these patients suggests that seizure risk may be multifactorial and also that PHT is a weak convulsant. We conclude that PHT at very high concentrations can rarely exacerbate seizures or even precipitate generalized status in some epileptic patients, a paradoxical effect.
I Osorio; T H Burnstine; B Remler; R Manon-Espaillat; R C Reed
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Epilepsia     Volume:  30     ISSN:  0013-9580     ISO Abbreviation:  Epilepsia     Publication Date:    1989 Mar-Apr
Date Detail:
Created Date:  1989-04-24     Completed Date:  1989-04-24     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  2983306R     Medline TA:  Epilepsia     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  230-4     Citation Subset:  IM    
Department of Neurology, University Hospitals of Cleveland, Case Western Reserve University, Ohio 44106.
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MeSH Terms
Dose-Response Relationship, Drug
Epilepsy / drug therapy
Middle Aged
Phenytoin / administration & dosage,  adverse effects*
Retrospective Studies
Seizures / chemically induced*
Reg. No./Substance:

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