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Adverse drug reactions
Dyskinesia during concomitant usage of phenytoin and capecitabine
  1. Dinesh Keerty MD FACP1,
  2. Rene Kessler MD2,
  3. Viktoriya Koverzhenko APRN1,
  4. Edwin Peguero MD3
  1. 1 Internal Medicine, Moffitt Cancer Center, Tampa, Florida, USA
  2. 2 Medical Student Year 4, Ponce Health Sciences University, Ponce, Puerto Rico
  3. 3 Neurology, Moffitt Cancer Center, Tampa, Florida, USA
  1. Correspondence to Dinesh Keerty, Department of Internal Medicine, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33602, USA; dinesh.keerty{at}gmail.com

http://dx.doi.org/10.1136/postgradmedj-2020-138063

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    INTRODUCTION

    Phenytoin is an anticonvulsant used for prevention of tonic–clonic and partial seizures via blockage of voltage-gated sodium channels. Side effects of phenytoin include hypotension, rash, nausea, nystagmus, dizziness, somnolence and ataxia. Rare side effects (<1%) include confusion, psychosis, photophobia, myopathy and dyskinesia.1 We present a patient with dyskinesia that resulted from phenytoin toxicity during concomitant usage of capecitabine therapy.

    CASE PRESENTATION

    A Caucasian patient presented with confusion and dyskinesia over the past 2 weeks. The patient reported a 2-week history of progressive difficulty with short-term memory and involuntary movements with her limbs. She has been treated for Stage IIIA triple-negative breast cancer for the past 2 years. Two months prior to presentation, she underwent a craniotomy for removal of new brain lesions. She was …

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    Footnotes

    • Contributors DK: provided the design of the work, analysis of data, drafting the work for important intellectual content and had done final approval of the version published and accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. RK: provided contributions to the acquisition, analysis of data, drafting the work and had done final approval of the version published. VK: provided contributions to the acquisition, analysis of data, drafting the work and had done final approval of the version published. EP: provided the design of the work, analysis of data, drafting the work for important intellectual content and had done final approval of the version published.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.