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Case Report

Phenytoin Induced Cerebellar Atrophy-A Case Report

1,6Post Graduate Student, Dept. of General Medicine, Kamineni Institute of Medical Sciences(KIMS), Narketpally, 2Associate Professor, Dept. of General Medicine, KIMS, Narketpally, 3Assistant Professor, Dept. of General Medicine, Kamineni Academy of Medical Sciences and Research center, Hyderabad, 4Professor & H.O.D., Dept. of General Medicine, KIMS, Narketpally, 5Assistant Professor, Dept. Of Radiology, KIMS, Narket- pally.


Epilepsy is one of the common disorders encountered by a physician for which Phenytoin is routinely prescribed. Patients on Phenytoin might develop sedation, dizziness, swaying, rash and gum hypertrophy as drug related side effects.1 Cerebellar Atrophy is infrequently reported complication of long term phenytoin toxicity. We report a case of 25year old male, who presented with complaints of giddiness and swaying while walking. He is a known epileptic and has been on Phenytoin for the past 14 years. On evaluation, MRI Brain revealed cerebellar atrophy and his serum phenytoin level was 32mcg/ml which was far above the recommended therapeutic level of 10-20 mcg/ml.1 Thus, Cerebellar atrophy in this male is probably due to long term supra therapeutic levels of Phenytoin. Therefore, we recommend frequent therapeutic drug monitoring of Phenytoin.

Keys words: Epilepsy, Phenytoin, Cerebellar Atrophy.