CT FINDINGS FOLLOWING DIPHENYLHYDANTOIN INTOXICATION

CT findings in three female epileptic patients are presented. The patients were treated with toxic doses of the anticonvulsant diphenylhydontoin, leading to irreversible ataxia of varying severity. CT shows cerebellar atrophy, including discernible sulci, a dilaalted 4th ventricle, basal cisterns, and subarachnoid space. These effects of severe DPH toxicity are relevant in the differential diagnosis of ''idiopathic'' and other toxic and systemic atrophies, as well as dysontogenetic lesions of the cerebellum. The reports of McLain et al. [5] and Koller et al. demonstrated the possible morphological consequences of long and/or high-dose treatment with phenylhadantoin in epileptic patients. Koller et al. stressed that the vermal region seemed to be especially affected. We observed 7 epileptic patients, 6 female and 1 male, suffering from chronic, irreversible ataxia secondary to high-dose DPH schedules. We discussed this topic in detail elsewhere [1]. In the current report we present the CT findings in three of these patients, all female, and two of them previously investigated by CT. These initial CT studies failed to show signs of cerbellar atrophy.