Vestibular and hearing manifestations of phenytoin toxicity: A retrospective series

Ear, Nose & Throat Journal, June, 2001 by Juan I. De Diego, Maria P. Prim, Sol Marcos, Maria J. De Sarria, Javier Arpa, Javier Gavilan

Table 2. Diagnostic criteria for acute and chronic phenytoin toxicity

Acute

Ataxia

Dysarthria

Dysdiadochokinesia

Dysmetria

Pathologic Romberg test

Spontaneous nystagmus

Chronic

Hyporeflexia

Sensitive neuropathy

Table 3. Clinical manifestations in our series of 23 patients
                                n (%)
Cerebellar signs
 Dysdiadochokinesia            5 (21.7)
 Dysmetria                     6 (26.1)
Abnormal audiometry *          4 (17.4)
Abnormal Romberg test          6 (26.1)
Abnormal tandem test           4 (17.4)
Abnormal Unterberger's test    5 (21.7)
IIIrd cranial nerve paralysis     0
IVth cranial nerve paralysis      0
Vth cranial nerve impairment
 Corneal anesthesia            1 (4.4)
 Facial anesthesia             1 (4.4)
VIth cranial nerve paralysis      0
VIIth cranial nerve paralysis  2 (8.7)
(*)All 4 patients had presbyacusis.