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X Ye, Q Lin, P Lian, X Gu; Oculomotor Impairment in the patients with Dilantin Intoxication . Invest. Ophthalmol. Vis. Sci. 2002;43(13):2655.
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Purpose: Dilantin(Phenytoin) is used to treat seizures and epilepsy. It's side effects include drowsiness, dizziness, or blurred vision. Ohter side effects include stomach upset, headache, muscle twitching, sleeping disturbances, uncoordinated movements and uncontrolled side-to-side eye movments. The aim of this study is to find out the characteristics of saccade, smooth pursuit and optokinetic nystagmus in the patients with dilantin intoxication. Methods: Non-predictable saccade of pseudorandom step tracking at the rates of 0.5-1 Hz and fixed amplitude 10 degree, smooth pursuit with fixed amplitude 10 degree but different frequency ( sinusoidal 0.5Hz, 1Hz and 1.5 Hz) and full-field optokinetic nystagmus at constant speed of 30 degree/s and 60degree/s were observed in left and right eyes (respectively) of 7 patients with dilantion intoxication and 60 age-matched normal controls. Using electrooculography (EOG) technique, the change of electric field potential with eye movements was input into the computer with silver-silver chloride electrodes (temporal, nasal and common electrode). The parameters including amplitude, peak velocity, latency and directional preponderance (PD) of saccade, velocity, gain and DP of pursuit and the frequency of beat. The fast and slow component velocities of optokinetic nystagmus were automated analyzed.by the computer. Results: Abnormalities of eye movements were found in the patients with dilantin intoxication. Hypometria, reduced peak velocity, increased latency and duration were found in saccade. During pursuit, the velocity was lower at frequencies of 1.0Hz and above. The frquency of beat, the fast and slow component velocities of optokinetic nystagmus were also reduced. Conclusion: Patients with dilantin intoxication have oculomotor impairment.The performance of eye movements could be used as a marker to monitor the drug intoxication.
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