A40-year-old man has been diagnosed with seizure 2 years ago, and an MRI of the brain revealed no structural lesions. She was started on phenytoin 4 since then. He is doing well with controlled seizure symptoms. On routine physical examination, you notice the findings shown in the photo below. Which of the following is most likely responsible for the condition of this patient's teeth and gums?

Question

A40-year-old man has been diagnosed with seizure 2 years ago, and an MRI of the brain revealed no structural lesions.  She was started on phenytoin 4 since then. He is doing well with controlled seizure symptoms.  On routine physical examination, you notice the findings shown in the photo below.  Which of the following is most likely responsible for the condition of this patient's teeth and gums?

Quizplus · Accepted Answer

Eductional Objective: Gingival hyperplasia is a common side effect of phenytoin and is sometimes reversible when phenytoin is withdrawn.  Phenytoin causes increased expression of platelet-derived growth factor (PDGF).  When gingival macrophages are exposed to increased amounts of PDGF, they stimulate proliferation of gingival cells and alveolar bone.  Phenytoin toxicity mainly affects the cerebellum and vestibular system, causing ataxia and nystagmus.

A40-Year-Old Man Has Been Diagnosed with Seizure 2 Years Ago