Two patients with intractable epilepsy who had been treated with various combinations of anticonvulsant drugs developed phenytoin encephalopathy. In both patients choreo-athetoid involuntary movements were prominent. Blood phenytoin concentrations were above 30 mug/ml. When phenytoin was given in smaller doses and its level in the blood fell the involuntary movements and other clinical manifestations disappeared.
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McLellan et al. (1974) studied this question.
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