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Phenobarbitone induced gingival hyperplasia
  1. S Sinha,
  2. V Kamath,
  3. G R Arunodaya,
  4. A B Taly
  1. Department of Neurology, National Institute of Mental Health and NeuroSciences, (NIMHANS), Bangalore 560 029, India.
  1. Correspondence to:
 Professor Arun B Taly;

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Among the long term adverse effects of anticonvulsants, gum hyperplasia is cosmetically disturbing and can give rise to complications such as bleeding and gingivitis.1,2 Long term use and high doses of phenytoin sodium (diphenylhydantoin) have been implicated in the occurrence of gingival hyperplasia.3 Serum phenytoin level in these patients are high.3 Rarely other drugs such as primidone, sodium valproate, nifedipine, and cyclosporin have also been implicated.1,2 Treatment consists of stopping the offending agent and providing corrective surgery.4 Phenobarbitone (phenobarbital) has not yet been reported to cause gum hyperplasia. We describe a patient who developed this complication in association with the long term use of phenobarbitone.

Case report

A 26 year old man had been suffering from hot water reflex epilepsy and primary generalised tonic-clonic seizures since he was 12 years of age. The seizures were poorly controlled because of his inability to avoid taking hot baths, inadequate dosage of anticonvulsants, and poor compliance. …

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