A RARE CASE OF PHENYTOIN INDUCED CHOREA & PHENYTOIN HYPERSENSITIVITY SYNDROME

Abstract

Phenytoin is widely prescribed anticonvulsant for seizure disorder.However, it is associated with a lot of side effects of which chorea and Anticonvulsant hypersensitivity syndrome(AHS) are rare. Occurence of Phenytoin induced chorea and AHS at the same time is a very rare phenomenon .Hereby we are presenting a case where both occurred at same time.CASE:57 yrs old female presented to outpatient department with complaints of abnormal facial and limb movements, fever ,rash. She was on phenytoin for one month.She developed phenytoin induced chorea and AHS at the same time. Phenytoin was immediately withdrawn from the patient and started on levetiracetam .Patient’s chorea and AHS recovered in 1 week. Conclusion: phenytoin induced chorea and AHS presenting in same time in the same patient is very rare.The early recognition of multi organ involvement is important as stopping the drug results in complete recovery. Anticonvulsant Hypersensitivity Syndrome should be considered in any patient treated with phenytoin, carbamazepine or phenobarbitone who presents with fever, rash or lymphadenopathy. The medication should be immediately discontinued pending investigation. Although the syndrome is rare, recognition is essential to avoid considerable morbidity and possible fatal outcome.