REFLEX SYMPATHETIC DYSTROPHY ASSOCIATED WITH ANTIEPILEPTIC DRUGS

Reflex sympathetic dystrophy syndrome (RSDS) complicating antiepilepti c drug (AED) therapy is not well acknowledged in the neurologic litera ture. We report 4 patients with reflex sympathetic dystrophy that occu rred while they were receiving AEDs. All patients had shoulder and han d involvement, which in 2 was bilateral, and 1 had ipsilateral foot in volvement. Two patients did not respond to a change in AEDs, but all i mproved with a course of prednisone. One patient with phenobarbital (P B)-associated RSDS relapsed on inadvertent rechallenge with secobarbit al. A review of the literature showed that several other fibrosing dis orders are associated with AED administration, including Dupuytren's c ontractures, frozen shoulder, plantar and hand nodules, and Peyronie's disease. RSD associated with AEDs is important to recognize because i t may result in permanent disability if treatment is delayed.