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KMID : 0378019750180040454
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New Medical Journal
1975 Volume.18 No. 4 p.454 ~ p.458
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Study on the Iatrogenic Disorders in Convulsive Disease
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Abstract
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The case histories of two patients who suffered Dilantin intoxication are described briefly, The one
patient showed the clinical picture of theacute cerebeller syndrome.
The patient improved when the drug was withdrawn but abnormal-signs persisted for several month . Phenobarbitone and Diazepam were substituted for Dilantinand in one year all iatrogenic disturbances were completely disappeared,
The another patient, however, present the pictures, which suggest the permanent cerebefar-damage. After reducing the dosage of Dilantin-Medication, the most ´iatrogenic disturbances, such as skin rashes, gum hypertrophy, edematous swelling of the face and gastro-intestinal troubles, were almost abolished, but the signs of the cerebellar dysfunction were rather worsened progressively. The patient showed the frequent seizure attack during the high dosage of Dilantin which may be due -o the paradoxical exacervation of the convulsive seizure by the high dosage of this drug.
It also mentioned that the inhibition of the Na+, K+, Mg++, ATPase enzyme system by Dilantin may
be important in causing neuronal damage, especially cerebellum. The fact that seizure frequency seems to be increased by Dilantin overdosage could also be explained on the basis of inhibition of the enzyme system causing a rise in intraneuronal sodium concentration and consequent decrease in membrane stability.
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