Seizures in 9 of these 14 patients probably resulted from poor seizure control despite high phenytoin levels, but in 5 cases, attacks were attributed to phenytoin toxicity. doi: 10.1002/14651858.CD002216.pub2.Neurology. Although some patients receiving phenytoin may achieve seizure control with "subtherapeutic" levels (i.e., <40 micromol/L), others may need supratherapeutic levels, as was the case with this patient. No demographic, metabolic, neuropsychiatric, or therapeutic variables were predictive; nor were any other symptoms of toxicity particularly likely to be found in association with seizures. Name must be less than 100 characters The only factor that seemed to correlate with seizures was a serum phenytoin level over 30 μg/ml. However, in some situations higher serum concentrations are needed to control seizures. It is useful for the prevention of tonic-clonic seizures and focal seizures, but not absence seizures. NOTE: The first author must also be the corresponding author of the comment.Your role and/or occupation, e.g. doi: 10.1097/00007691-200206000-00010. The levels have to be controlled carefully as in case they are too low, seizures may occur.
Seizures are an occasional manifestation of phenytoin toxicity, particularly when levels are high.We have changed the login procedure to improve access between AAN.com and the Neurology journals. If I had a patient like that I would consider how high the levels were and whether the patient was having side effects before deciding whether to hold a few doses or to lower the maintenance dose. Historically, phenytoin has been used as an antidysrhythmic agent, especially in the treatment of dysrhythmias due to digoxin toxicity.
(For instructions by browser, please click the instruction pages below). Wolters Kluwer Phenytoin is a sodium channel blocker (Type 1B anti-arrhythmic) that decreases rapid neuronal firing; Oral phenytoin is rarely associated with cardiovascular adverse events except with low albumin levels and very high serum phenytoin levels 1; Propylene glycol is the diluent of the IV formulation of phenytoin (that is, phenytoin sodium) Unable to load your collection due to an error 2006;45(11):1061-75. doi: 10.2165/00003088-200645110-00002. 2007 Jan 24;(1):CD002216.
Clipboard, Search History, and several other advanced features are temporarily unavailable. The upper limit for the therapeutic serum concentration of phenytoin is considered to be 80 micromol/L.
1996 Jun;46(6 Suppl 1):S24-8. Among 50 patients with phenytoin intoxication, 14 had seizures during the episode. COVID-19 is an emerging, rapidly evolving situation. Please enable it to take advantage of the complete set of features!
Seizures in 9 of these 14 patients probably resulted from poor seizure control despite high phenytoin levels, but in 5 cases, attacks were attributed to phenytoin toxicity. Clinicians should be careful not to treat "numbers" (i.e., serum concentrations), but rather the patient's clinical condition, with a careful balance between therapeutic advantage and adverse effects. You will be redirected to a login page where you can log in with your AAN ID number and password. doi: 10.1097/00007691-200206000-00010. Reply. May 24, 2018 at 12:12 PM. Phenytoin level high (166944003) ... Association of galactose single-point test levels and phenytoin metabolic polymorphisms with gingival hyperplasia in patients receiving long-term phenytoin therapy. 2016 Oct 1;116(4):1924-1936. doi: 10.1152/jn.01060.2015. Enter and update disclosures at The most widely read and highly cited peer-reviewed neurology journal Unable to load your delegates due to an error
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