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William H. Theodore, MD
National Institutes of Health Bldg 10, Room 5C-205 Bethesda, MD 20829

Arch Neurol. 1995;52(3):232.

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I read with interest the valuable study by Ney et al¹ on cerebellar atrophy in patients with complex partial seizures who were taking phenytoin. Sixteen of their 36 patients had no history of generalized tonicclonic seizures. Among these 16 patients, was there a higher incidence of atrophy than that expected in the control population? In a study using positron emission tomography with ¹⁸F-deoxyglucose, we found that cerebellar glucose metabolism was reduced in patients with complex partial seizures compared with control subjects.² In our study, the effects of phenytoin were weak. I agree with Ney et al that phenytoin may have some influence on the development of cerebellar atrophy in patients with epilepsy, but I do not think that the effect is likely to be of clinical importance. Lindvall et al³ described a patient with acute subarachnoid hemorrhage who never had seizures, but who developed ataxia and . . . [Full Text PDF of this Article]

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