TY - JOUR
T1 - Neurotoxicity in liver transplant recipients with cyclosporine immunosuppression
AU - Wijdicks, Eelco F.M.
AU - Wiesner, Russell H.
AU - Krom, Ruud A.F.
PY - 1995/11
Y1 - 1995/11
N2 - We studied the clinical features, blood levels of cyclosporine, and neuroimaging findings in 46 patients with cyclosporine neurotoxicity after liver transplantation. The clinical presentation of cyclosporine neurotoxicity was characterized by tremulousness and restlessness in all patients and was associated with acute confusional state and psychosis in 20 patients, seizures in eight, speech apraxia or action myoclonus speech in three, and cortical blindness in two. In 35 patients, cyclosporine neurotoxicity occurred during IV treatment. Neuroimaging studies showed only minor white matter abnormalities in two patients despite dramatic clinical presentations, including speech difficulties, seizures, and cortical blindness. In only 19 of 31 patients (61%) did trough levels of cyclosporine suggest neurotoxicity. Neurologic findings were reversible in all patients after cyclosporine was withheld and then given in lower dosage. In three patients, substituting FK 506 did not result in neurotoxicity.
AB - We studied the clinical features, blood levels of cyclosporine, and neuroimaging findings in 46 patients with cyclosporine neurotoxicity after liver transplantation. The clinical presentation of cyclosporine neurotoxicity was characterized by tremulousness and restlessness in all patients and was associated with acute confusional state and psychosis in 20 patients, seizures in eight, speech apraxia or action myoclonus speech in three, and cortical blindness in two. In 35 patients, cyclosporine neurotoxicity occurred during IV treatment. Neuroimaging studies showed only minor white matter abnormalities in two patients despite dramatic clinical presentations, including speech difficulties, seizures, and cortical blindness. In only 19 of 31 patients (61%) did trough levels of cyclosporine suggest neurotoxicity. Neurologic findings were reversible in all patients after cyclosporine was withheld and then given in lower dosage. In three patients, substituting FK 506 did not result in neurotoxicity.
UR - http://www.scopus.com/inward/record.url?scp=0029400646&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0029400646&partnerID=8YFLogxK
U2 - 10.1212/WNL.45.11.1962
DO - 10.1212/WNL.45.11.1962
M3 - Article
C2 - 7501141
AN - SCOPUS:0029400646
VL - 45
SP - 1962
EP - 1964
JO - Neurology
JF - Neurology
SN - 0028-3878
IS - 11
ER -