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Diagnostically Confusing Complications of Diphenylhydantoin Therapy: A Review

Ann Intern Med. 1963;59(6):914-930. doi:10.7326/0003-4819-59-6-914
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Diphenylhydantoin (DPH) (Dilantin®) has been widely used in the therapy of grand mal and psychomotor epilepsy since 1938 (1). The common complications were recognized early (2, 3). Cerebellar incoordination is the most frequent neurologic complication, but other diagnostically confusing neurologic lesions may occur, such as hemiplegia (4), extraocular palsy (5), and meningeal irritation with pleocytosis and elevated protein in the cerebrospinal fluid (6). Gingival hyperplasia, due to excessive deposition of collagen, has been observed in 6 to 62 per cent of patients receiving DPH (7). Nausea and abdominal pain may result from the chemical irritation of the alkaline salt. Dermatitis,




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