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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Does Phenytoin Cause Loss Of Balance?

I take 3 pills at night before going to bed. Currently the level in my blood is 20.2, which has increased Over the month. I have experienced loss of balance and feet dragging recently. Could the increase in the level of phenytoin cause this problem?
Tue, 27 Dec 2016
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General & Family Physician,  's  Response
Hi & Welcome.
Phenytoin is a commonly prescribed anticonvulsant used to treat most types of seizure disorders including generalized tonic clonic epilepsy.

Since it has got a low therapeutic index, a slight increase in its dose results in acute toxicity which is characterized by abnormal gait (bradykinesia, truncal ataxia). Ataxia is very typical with elevated phenytoin levels, and may lead to falls and consequent trauma. It may also result in nystagmus (horizontal, vertical) and diplopia.

The serum therapeutic level of Phenytoin should be in the range is 10-20 mcg/mL.

Based on the history given you seem to have developed features suggestive of Phenytoin toxicity. You should visit the ER immediately for proper clinical assessment and treatment.

Hope the advice given above would be useful in getting an early treatment.

Kindly rate the answer if you are convinced.
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Does Phenytoin Cause Loss Of Balance?

Hi & Welcome. Phenytoin is a commonly prescribed anticonvulsant used to treat most types of seizure disorders including generalized tonic clonic epilepsy. Since it has got a low therapeutic index, a slight increase in its dose results in acute toxicity which is characterized by abnormal gait (bradykinesia, truncal ataxia). Ataxia is very typical with elevated phenytoin levels, and may lead to falls and consequent trauma. It may also result in nystagmus (horizontal, vertical) and diplopia. The serum therapeutic level of Phenytoin should be in the range is 10-20 mcg/mL. Based on the history given you seem to have developed features suggestive of Phenytoin toxicity. You should visit the ER immediately for proper clinical assessment and treatment. Hope the advice given above would be useful in getting an early treatment. Kindly rate the answer if you are convinced.