Case of Fosphenytoin Induced Acute Cerebellar Dysfunction and Pituitary Bleed Causing Central Diabetes Insipidus in a Case of AML M2 during Allogenic Hematopoietic Stem Cell Transplant

International Journal of Pharmacology and Clinical Sciences, 2012, 1, 4, 111-114.
Published: December 2012
Type: Case Report
Authors: Eriat Govind, Radheshyam Naik, Srinivas BJ, and Intezar Mehdi

Author(s) affiliations:
Eriat Govind1*, Radheshyam Naik2, Srinivas BJ3, Intezar Mehdi4

1Registrar,
2Chief Medical Oncologist,
3Resident Medical Oncologist,
4Pediatric Oncologist Stem Cells and Bone Marrow Transplant, Health Care Global Enterprises Ltd, Bangalore, Karnataka, India.

Abstract

Neuroprotectors such as phenytoin, fosphenytoin, clonazepam, or levetiracetam are often used prior to the conditioning regimen to prevent seizures caused due to busulfan during bone marrow transplant. Fosphenytoin and levetiracetam are used instead of phenytoin as they are readily soluble and do not need a vehicle such as polyethylene glycol or ethanol, which increases the risk of tissue and cardio toxicity. We report a case of acute toxicity in the form of cerebral bleed during intravenous administration of fosphenytoin and its subsequent management in a patient undergoing busulfan treatment prior to allogenic transplant.

Keywords: Bone Marrow Transplantation, Busulfan, Conditioning Regimen, Fosphenytoin, Levetiracetam, Neuroprotector, Phenytoin

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