Nystagmus is a potential ocular sign associated with which anticonvulsant?

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Study for the NBEO Part II TMOD Exam. Prepare with flashcards and multiple choice questions, each with hints and explanations. Get ready for your exam!

Multiple Choice

Nystagmus is a potential ocular sign associated with which anticonvulsant?

Explanation:
Nystagmus is a classic dose-related sign of phenytoin toxicity. Phenytoin works by blocking voltage-gated sodium channels, which dampens neuronal firing. When levels rise, the oculomotor and vestibular pathways in the brain are affected early, leading to involuntary eye movements (nystagmus) along with other signs like ataxia and diplopia. Because nystagmus often appears before more severe CNS symptoms, it’s an important early warning that the drug dose may be too high and needs adjustment. Lamotrigine, topiramate, and carbamazepine can cause visual or ocular side effects, but nystagmus is most classically associated with phenytoin toxicity.

Nystagmus is a classic dose-related sign of phenytoin toxicity. Phenytoin works by blocking voltage-gated sodium channels, which dampens neuronal firing. When levels rise, the oculomotor and vestibular pathways in the brain are affected early, leading to involuntary eye movements (nystagmus) along with other signs like ataxia and diplopia. Because nystagmus often appears before more severe CNS symptoms, it’s an important early warning that the drug dose may be too high and needs adjustment.

Lamotrigine, topiramate, and carbamazepine can cause visual or ocular side effects, but nystagmus is most classically associated with phenytoin toxicity.

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