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Grand mal seizures and acute intermittent porphyria

The problem of differential diagnosis and treatment

Metabolism Branch of the National Cancer Institute, National Institutes of Health, Bethesda, Maryland.

A 36-year-old white man had both acute intermittent porphyria and long-standing idiopathic grand mal seizures. Diphenylhydantoin apparently adversely affected both the clinical and biochemical parameters of the acute intermittent porphyria. Comparison of urinary levels of the porphyrin precursors, delta aminolevulinic acid and porphobilinogen, under controlled diet conditions before and after withdrawal of diphenylhydantoin, showed that this drug accounted for approximately one-half of the porphyrin precursor excretion. Significant clinical improvement of the porphyria followed withdrawal of the diphenylhydantoin. Bromides appeared to be approximately as effective as diphenylhydantoin for seizure control in this patient.

Received for publication May 16, 1975.

Dr. Tschudy's address Is National Institutes of Health, Bldg. 10, Room 4N102, Bethesda, MD 20014.

This article has been cited by other articles:

				P. W. Kaplan and D. V. Lewis Juvenile Acute Intermittent Porphyria With Hypercholesterolemia and Epilepsy: A Case Report and Review of the Literature J Child Neurol, January 1, 1986; 1(1): 38 - 45. [Abstract] [PDF]