Neurophysiologic evaluation of cyclosporine toxicity associated with bone marrow transplantation

L. L. Edwards, Z. K. Wszolek, M. M. Normand

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9 Scopus citations

Abstract

Introduction– Cortical blindness, a rare form of cyclosporine (CSA) neurotoxicity, has previously been described in only nine bone marrow transplant (BMT) recipients. Methods ‐ Our institution averages 35 allogeneic BMT's per year. In the past year we have seen two women with reversible cortical blindness secondary to CSA toxicity. Results ‐ Age (years) (Case 1; Case 2): 32; 22. Day post‐BMT: 41; 50. Peak CSA level (ng/ml): 1159; 632. Both had a history of renal toxicity requiring adjustment of CSA dosage. MRI ‐ both with diffuse white matter changes. EEG‐both with moderate to severe generalized slowing. Visual evoked potentials were markedly prolonged in both. Auditory evoked potentials: minimally abnormal; normal. Somatosensory evoked potentials ‐ both normal. Prompt improvement occurred with discontinuation of CSA. Followup neurophysiologic evaluations were normal, however structural changes remained on MRI. Conclusion ‐ As neurophysiologic studies closely follow the clinical status they should be included in the evaluation and followup of CSA neurotoxicity.

Original languageEnglish (US)
Pages (from-to)423-429
Number of pages7
JournalActa neurologica Scandinavica
Volume92
Issue number5
DOIs
StatePublished - Nov 1995

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Keywords

  • bone marrow transplantation
  • cyclosporine neurotoxicity
  • neurophysiologic evaluation

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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