Dystonia phenytoin

Levodopa or dopamine agonists produce diverse dyskinesias as a dose-related phenomenon in patients with Parkinson s disease dose reduction reverses them. Chorea may also develop in patients receiving phenytoin, carbamazepine, amphetamines, lithium, and oral contraceptives, and it resolves with discontinuance of the offending medication. Dystonia has resulted from administration of dopaminergic agents, lithium, serotonin reuptake inhibitors, carbamazepine, and metoclopramide and postural tremor from theophylline, caffeine, lithium, valproic acid, thyroid hormone, tricyclic antidepressants, and isoproterenol. 

Choreoathetosis is the usual movement disorder due to phenytoin, but more recently 2 cases of dystonia associated with choreoathetosis have been described the abnormal movements disappeared in both patients after withdrawal of the phenytoin (11 ). 

Chalhub, K. G., Devivo, D. C. and Volpe, J. J. (1976) Phenytoin-induced dystonia and choreo-athetosis in two retarded epileptic children. A eir-rology, 26, 494. 

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