gms | German Medical Science

57th Annual Meeting of the German Society of Neurosurgery
Joint Meeting with the Japanese Neurosurgical Society

German Society of Neurosurgery (DGNC)

11 - 14 May, Essen

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Acute rhabdomyolysis: rapid onset after anticonvulsive treatment with phenytoin

Akute Rhabdomyolyse: unmittelbares Auftreten nach Behandlungsbeginn mit Phenytoin

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  • corresponding author O. Müller - Universitätsklinikum Essen, Neurochirurgische Klinik und Poliklinik, Essen
  • T. Gasser - Universitätsklinikum Essen, Neurochirurgische Klinik und Poliklinik, Essen
  • D. Müller - Universitätsklinikum Essen, Neurochirurgische Klinik und Poliklinik, Essen
  • B. Schoch - Universitätsklinikum Essen, Neurochirurgische Klinik und Poliklinik, Essen
  • H. Wiedemayer - Universitätsklinikum Essen, Neurochirurgische Klinik und Poliklinik, Essen
  • D. Stolke - Universitätsklinikum Essen, Neurochirurgische Klinik und Poliklinik, Essen

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocP 02.12

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2006/06dgnc229.shtml

Published: May 8, 2006

© 2006 Müller et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: To report two cases of a rapid onset of acute rhabdomyolysis after initiation of the medical treatment with phenytoin in symptomatic epilepsia, along with detailed blood chemistry findings and therapeutic management.

Methods: Acute rhabdomyolysis is a life-threatening disorder, that can be triggered by various causes. Pathophysiologically it is an immuno-allergic reaction affecting the skelettal muscles with pathognomonical features of its clinical appearance and blood chemistry findings, leeding to severe disability or death in worse cases. Rhabdomyolysis has been described before in the treatment with phenytoin, developing several weeks after its first administration. Two patients in our clinic presented clinical signs of acute rhabdomyolysis after initiation of anticonvulsive treatment with phenytoin, that was confirmed in blood chemistry findings.

Results: Blood chemistry revealed acute rhabdomyolysis in two patients, who were treated with phenytoin for symptomatic epilepsia. Intensive-care management with hypervolemic treatment and forced diuresis could prevent hemodialysis in both cases. Recovery was uneventful in both patients.

Conclusions: This is the first reported sudden onset of an acute rhabdomyolysis after administration of phenytoin for syptomatic epilepsia. One must be aware of this complication and it is mandatory, that routine blood examinations have to be done, when a patient is treated with phenytoin for seizure control. Acute rhabdomyolysis has to be managed by intensive-care treatment with hypervolemia and forced diuresis to prevent hemodialysis.