PDF(Pubmed)
Abstract：
Phenytoin (PHT) was first synthesized as a barbiturate derivative and was approved in 1953 by the Food and Drug Administration. This work aimed to review the pathophysiology, epidemiology, clinical presentation, and treatment of PHT-associated movement disorders (MDs). Studies were searched in relevant databases (ScienceDirect, Google Scholar, Excerpta Medica, Latin American and Caribbean Health Sciences Literature, Medline, and Scientific Electronic Library Online) and were selected by two reviewers irrespective of language between 1963 and 2021. Papers of PHT-induced ataxia alone or tremor were excluded. In total, 127 reports with 219 individuals who developed MDs associated with PHT were encountered. MDs found: 126 dyskinesias, 49 myoclonus, 19 dystonia, 14 parkinsonism, 6 tics, 3 stuttering, and 2 restless legs syndrome. The mean age was 35 years (standard deviation [SD]: 23.5) and the predominant sex was male (53.4%). The mean PHT dose when the MD took place was 370.4 mg (SD: 117.5). A serum PHT concentration was reported in 103 cases, ranging from 4 to 110 μg/mL (median: 27.7 μg/mL). No significant relationship was found between PHT dose and age or PHT level. The mean onset time of PHT-associated MD was 23.4 months (SD: 4.4). The mean recovery time after MD management was 3.7 weeks (SD: 1.1). Regarding management, the most common form was PHT withdrawal in 90.4%. 86.3% of the individuals recovered fully. PHT-induced MD was extensively reported in the literature. Only general terms were used in the majority of the reports. The mechanisms underlying the adverse events caused by PHT probably depend on the presence of predisposing factors.
摘要：
苯妥英(PHT)首先作为巴比妥酸盐衍生物合成,并于1953年由食品和药物管理局批准。这项工作旨在回顾病理生理学，流行病学,临床表现,和PHT相关运动障碍（MD）的治疗。在相关数据库中搜索了研究(ScienceDirect，谷歌学者，医学节选,拉丁美洲和加勒比健康科学文献，Medline,和在线科学电子图书馆），并在1963年至2021年之间由两名审稿人选择，无论语言如何。排除单独的PHT诱导的共济失调或震颤的论文。总的来说,遇到了127例报告，其中有219例发生了与PHT相关的MD。MD发现：126项运动障碍，49肌阵挛症，19张力障碍，14帕金森病,6Tics,3口吃，和2个不宁腿综合征。平均年龄为35岁（标准差[SD]：23.5），主要性别为男性（53.4％）。MD发生时的平均PHT剂量为370.4mg(SD:117.5)。103例报告血清PHT浓度，范围从4到110μg/mL（中位数：27.7μg/mL）。在PHT剂量与年龄或PHT水平之间没有发现显着关系。PHT相关MD的平均发病时间为23.4个月(SD:4.4)。MD管理后的平均恢复时间为3.7周(SD:1.1)。关于管理，最常见的形式是90.4%的PHT戒断.86.3%的人完全恢复。文献中广泛报道了PHT诱导的MD。大多数报告只使用一般术语。PHT引起的不良事件的潜在机制可能取决于诱发因素的存在。
