Phenytoin
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Syncope: case report A 56-year-old man developed syncope during treatment with phenytoin. The man had a history of hypertension, seizure disorder and asthma presented to a hospital due to syncope. He was discharged earlier in the day following admission for dizziness due to supratherapeutic levels of phenytoin [Dilantin; dosage and route not stated]. At the time of discharge, his phenytoin level was still elevated at 24.5 µg/mL (initial value: 38.3 µg/mL). Upon discharge, he was asymptomatic, and he further mentioned that in the afternoon, he had visited a softball game and he was in the crowd watching the game. After about 30 minutes of standing, he started feeling light headed and hot, and the next thing he remembered was that, he was on the ground surrounded by people. The man was re-admitted due to syncope. His chest CT scan with angiography revealed bilateral underlying acute pulmonary embolism. He was treated with enoxaparin sodium [lovenox] and then discharged in a stable condition. Author comment: "He was just discharged earlier that day after being admitted for dizziness secondary to supratherapeutic levels of his phenytoin." Tso J. Trust the scores! using pre-test scoring systems with clinical gestalt in identifying pulmonary embolism in patient with syncope. Journal of Hospital Medicine 13 (Suppl. 1): No. 4, Jan 2018. Available from: URL: https:// 803432398 www.journalofhospitalmedicine.com/jhospmed/issues [abstract] - USA
0114-9954/19/1778-0001/$14.95 Adis © 2019 Springer Nature Switzerland AG. All rights reserved
Reactions 9 Nov 2019 No. 1778
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