[Verified Answer]: SHE HAS BEEN ON PHENYTOIN FOR SEVERAL DAYS…

SHE HAS BEEN ON PHENYTOIN FOR SEVERAL DAYS AFTER HAVING BEEN SWITCHED FROM VALPROIC ACID. SHE STATES SHE HAS HAD AN ACUTE CHANGE IN GAIT, UNCLEAR SPEECH, BLURRING OF VISION, TREMOR WITH MOVEMENT, AND LOSS OF HAND COORDINATION. SHE HAS NEVER HAD SYMPTOMS LIKE THIS BEFORE. SHE DENIES HEADACHE AND VERTIGO OR ANY OTHER COMPLAINTS.ON EXAMINATION, SHE HAS AN UNSTABLE GAIT AND POOR HAND-EVE COORDINATION.SHE IS NOTED TO HAVE NYSTAGMUS ALONG WITH A FINE TREMOR OF THE HAND WHEN SHE IS MOVING IT. A URINE DRUG SCREEN IS NEGATIVE. SHE HAS A COMPUTED TOMOGRAPHY CCTI SCAN AND LUMBAR PUNCTURE, WHICH ARE BOTH NORMAL. PHENYTOIN LEVELS ARE SLIGHTIY ELEVATED. SHE IS DIAGNOSED WITH CEREBELLAR ATAXIA, PROBABLY AS A SIDE EFFECT OF PHENYTOIN.