Vestibular and Hearing Manifestations of Phenytoin Toxicity: A Retrospective Series
We undertook a study to identify the vestibular and hearing abnormalities associated with phenytoin toxicity. Since October 1977, 23 patients with phenytoin toxicity have been referred to the Department of Otorhinolaryngology by the Department of Neurology for electro-oculographic (EOG) evaluation....
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| Published in | Ear, nose, & throat journal Vol. 80; no. 6; pp. 404 - 409 |
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| Main Authors | , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Los Angeles, CA
SAGE Publications
01.06.2001
Medquest Communications Sage Publications, Inc SAGE PUBLICATIONS, INC |
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| Online Access | Get full text |
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| Abstract | We undertook a study to identify the vestibular and hearing abnormalities associated with phenytoin toxicity. Since October 1977, 23 patients with phenytoin toxicity have been referred to the Department of Otorhinolaryngology by the Department of Neurology for electro-oculographic (EOG) evaluation. (There have been no cases of serious phenytoin toxicity seen in our department since August 1989.) In addition to EOG, all patients had undergone otoscopic, audiometric, and neurologic examinations. We found that the most common pathologic findings detected by EOG were abnormalities in pursuit tracking. The most common signs found on clinical exploration were cerebellar dysfunction and facial palsy. EOG findings in patients with phenytoin toxicity are compatible with cerebellar disease. |
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| AbstractList | We undertook a study to identify the vestibular and hearing abnormalities associated with phenytoin toxicity. Since October 1977, 23 patients with phenytoin toxicity have been referred to the Department of Otorhinolaryngology by the Department of Neurology for electrooculographic (EOG) evaluation. (There have been no cases of serious phenytoin toxicity seen in our department since August 1989.) In addition to EOG, all patients had undergone otoscopic, audiometric, and neurologic examinations. We found that the most common pathologic findings detected by EOG were abnormalities in pursuit tracking. The most common signs found on clinical exploration were cerebellar dysfunction and facial palsy. EOG findings in patients with phenytoin toxicity are compatible with cerebellar disease. We undertook a study to identify the vestibular and hearing abnormalities associated with phenytoin toxicity. Since October 1977, 23 patients with phenytoin toxicity have been referred to the Department of Otorhinolaryngology by the Department of Neurology for electro-oculographic (EOG) evaluation. (There have been no cases of serious phenytoin toxicity seen in our department since August 1989.) In addition to EOG, all patients had undergone otoscopic, audiometric, and neurologic examinations. We found that the most common pathologic findings detected by EOG were abnormalities in pursuit tracking. The most common signs found on clinical exploration were cerebellar dysfunction and facial palsy. EOG findings in patients with phenytoin toxicity are compatible with cerebellar disease. |
| Audience | Professional |
| Author | De Diego, Juan I. Marcos, Sol De Sarria, Maria J. Gavilan, Javier Prim, Maria P. Arpa, Javier |
| Author_xml | – sequence: 1 givenname: Juan I. surname: De Diego fullname: De Diego, Juan I. – sequence: 2 givenname: Maria P. surname: Prim fullname: Prim, Maria P. – sequence: 3 givenname: Sol surname: Marcos fullname: Marcos, Sol – sequence: 4 givenname: Maria J. surname: De Sarria fullname: De Sarria, Maria J. – sequence: 5 givenname: Javier surname: Arpa fullname: Arpa, Javier – sequence: 6 givenname: Javier surname: Gavilan fullname: Gavilan, Javier |
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| Cites_doi | 10.1111/j.1469-8749.1984.tb04510.x 10.1212/WNL.26.11.1031 10.1002/ana.410070106 10.1177/000992288502400902 10.1001/archinte.1958.00260230042007 10.1001/jama.1966.03110230136038 10.1212/WNL.15.9.823 10.1111/j.1365-2273.1992.tb01070.x 10.1001/archneur.1980.00500520076016 10.1001/archneur.1960.03840120030004 10.1016/S0022-3476(68)80172-6 10.1001/jama.1967.03130060159024 10.1136/jnnp.31.5.520 10.1177/000348947308200322 10.1056/NEJM195111082451903 |
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| Keywords | Human Peripheral vestibular syndrome Chemotherapy Treatment Toxicity Internal ear disease Auditory disorder ENT disease Anticonvulsant Phenytoin Hearing loss |
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| References | Manlapaz 1959; 55 Laubscher 1966; 198 Orth, Almeida, Walsh, Honda 1967; 201 Berger, Kovacs 1982; 2 Buchthal, Svensmark, Schiller 1960; 2 Howrie, Crumrine 1985; 24 Grillone, Myssiorek 1992; 17 Choonara, Rosenbloom 1984; 26 Tichner, Enselberg 1951; 245 Schreiner 1958; 102 Nozue, Mizuno, Kaga 1973; 82 Blair, Hallpike, Lascelles, Wingate 1968; 31 McLain, Martin, Allen 1980; 7 Campbell 1980; 37 Kokenge, Kutt, McDowell 1965; 15 Patel, Crichton 1968; 73 Spector, Davidoff, Schwartzman 1976; 26 Schmeisser 1952; 20 bibr14-014556130108000610 bibr9-014556130108000610 bibr13-014556130108000610 bibr8-014556130108000610 Berger J.R. (bibr5-014556130108000610) 1982; 2 Schmeisser M. (bibr15-014556130108000610) 1952; 20 bibr1-014556130108000610 bibr17-014556130108000610 bibr11-014556130108000610 bibr12-014556130108000610 bibr16-014556130108000610 bibr18-014556130108000610 bibr4-014556130108000610 Manlapaz J.S. (bibr6-014556130108000610) 1959; 55 bibr2-014556130108000610 bibr10-014556130108000610 bibr3-014556130108000610 bibr7-014556130108000610 |
| References_xml | – volume: 198 start-page: 1120 year: 1966 end-page: 1 article-title: Fatal diphenylhydantoin poisoning. A case report publication-title: JAMA contributor: fullname: Laubscher – volume: 31 start-page: 520 year: 1968 end-page: 3 article-title: Acute diphenylhydantoin and primidone poisoning treated by peritoneal dialysis publication-title: J Neurol Neurosurg Psychiatry contributor: fullname: Wingate – volume: 102 start-page: 896 year: 1958 end-page: 913 article-title: The role of hemodialysis (artificial kidney) in acute poisoning publication-title: AMA Arch Int M contributor: fullname: Schreiner – volume: 245 start-page: 723 year: 1951 end-page: 5 article-title: Suicidal sodium diphenylhydantoin poisoning publication-title: N Engl J Med contributor: fullname: Enselberg – volume: 15 start-page: 823 year: 1965 end-page: 9 article-title: Neurological sequelae following Dilantin overdose in a patient and in experimental animals publication-title: Neurology contributor: fullname: McDowell – volume: 26 start-page: 1031 year: 1976 end-page: 4 article-title: Phenytoin-induced ophthalmoplegia publication-title: Neurology contributor: fullname: Schwartzman – volume: 73 start-page: 676 year: 1968 end-page: 84 article-title: The neurologic hazards of diphenylhydantoin in childhood publication-title: J Pediatr contributor: fullname: Crichton – volume: 55 start-page: 73 year: 1959 end-page: 7 article-title: Abducens nerve palsy in dilantin intoxication. J Pediat, St publication-title: Louis contributor: fullname: Manlapaz – volume: 37 start-page: 178 year: 1980 end-page: 80 article-title: Periodic alternating nystagmus in phenytoin intoxication publication-title: Arch Neurol contributor: fullname: Campbell – volume: 201 start-page: 485 year: 1967 end-page: 7 article-title: Ophthalmoplegia resulting from diphenylhydantoin and primidone intoxication publication-title: JAMA contributor: fullname: Honda – volume: 17 start-page: 185 year: 1992 end-page: 91 article-title: Otolaryngologic manifestations of phenytoin toxicity publication-title: Clin Otolaryngol contributor: fullname: Myssiorek – volume: 26 start-page: 677 year: 1984 end-page: 8 article-title: Focal dystonic reaction to phenytoin publication-title: Dev Med Child Neurol contributor: fullname: Rosenbloom – volume: 82 start-page: 389 year: 1973 end-page: 94 article-title: Neurotological findings in diphenylhydantoine intoxication publication-title: Ann Otol Rhinol Laryngol contributor: fullname: Kaga – volume: 2 start-page: 624 year: 1960 end-page: 30 article-title: Clinical and electro-encephalographic correlations with serum levels of diphenylhydantoin publication-title: AMA Arch Neurol contributor: fullname: Schiller – volume: 2 start-page: 209 year: 1982 end-page: 11 article-title: Downbeat nystagmus with phenytoin publication-title: J Clin Neuroophthalmol contributor: fullname: Kovacs – volume: 20 start-page: 158 year: 1952 end-page: 66 article-title: Todliche Vergiftung mit Zentropil beim Kind. Kinderatzl publication-title: Praxis contributor: fullname: Schmeisser – volume: 24 start-page: 467 year: 1985 end-page: 9 article-title: Phenytoin-induced movement disorder associated with intravenous administration for status epilepticus publication-title: Clin Pediatr (Phila) contributor: fullname: Crumrine – volume: 7 start-page: 18 year: 1980 end-page: 23 article-title: Cerebellar degeneration due to chronic phenytoin therapy publication-title: Ann Neurol contributor: fullname: Allen – ident: bibr12-014556130108000610 doi: 10.1111/j.1469-8749.1984.tb04510.x – ident: bibr11-014556130108000610 doi: 10.1212/WNL.26.11.1031 – ident: bibr3-014556130108000610 doi: 10.1002/ana.410070106 – ident: bibr13-014556130108000610 doi: 10.1177/000992288502400902 – ident: bibr18-014556130108000610 doi: 10.1001/archinte.1958.00260230042007 – volume: 55 start-page: 73 year: 1959 ident: bibr6-014556130108000610 publication-title: Louis contributor: fullname: Manlapaz J.S. – ident: bibr16-014556130108000610 doi: 10.1001/jama.1966.03110230136038 – ident: bibr4-014556130108000610 doi: 10.1212/WNL.15.9.823 – volume: 2 start-page: 209 year: 1982 ident: bibr5-014556130108000610 publication-title: J Clin Neuroophthalmol contributor: fullname: Berger J.R. – ident: bibr2-014556130108000610 doi: 10.1111/j.1365-2273.1992.tb01070.x – volume: 20 start-page: 158 year: 1952 ident: bibr15-014556130108000610 publication-title: Praxis contributor: fullname: Schmeisser M. – ident: bibr8-014556130108000610 doi: 10.1001/archneur.1980.00500520076016 – ident: bibr17-014556130108000610 doi: 10.1001/archneur.1960.03840120030004 – ident: bibr1-014556130108000610 doi: 10.1016/S0022-3476(68)80172-6 – ident: bibr10-014556130108000610 doi: 10.1001/jama.1967.03130060159024 – ident: bibr7-014556130108000610 doi: 10.1136/jnnp.31.5.520 – ident: bibr9-014556130108000610 doi: 10.1177/000348947308200322 – ident: bibr14-014556130108000610 doi: 10.1056/NEJM195111082451903 |
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| SubjectTerms | Adolescent Adult Age Distribution Anticonvulsants - adverse effects Anticonvulsants - therapeutic use Biological and medical sciences Complications and side effects Drug toxicity and drugs side effects treatment Female Hearing Hearing Disorders - chemically induced Humans Incidence Male Medical sciences Medicine Middle Aged Otolaryngology Pharmacology. Drug treatments Phenytoin Phenytoin - adverse effects Phenytoin - therapeutic use Practice Prognosis Retrospective Studies Risk Assessment Risk Factors Seizures - drug therapy Sex Distribution Toxicity: respiratory system, ent, stomatology Vestibular Diseases - chemically induced |
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| Title | Vestibular and Hearing Manifestations of Phenytoin Toxicity: A Retrospective Series |
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