Convulsions associated with cyclosporin A.

O'Sullivan, D

doi:10.1136/bmj.290.6471.858-a

Cited by 35 publications

(13 citation statements)

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“…Intention tremor, as part of a cerebellar syndrome is less frequent [2,59,66]. A review of data collected on 3000 kidney transplant recipients and nearly 800 BMT patients, and a study of nearly 400 liver transplant patients revealed the incidence of tremor to be 12-21% [44,71]. Tremor is more frequent with high CsA levels, but normal blood levels do not preclude the presence of tremor.…”

Section: Tremormentioning

confidence: 99%

“…Large series reported an incidence of CsA-related seizures of 1.5-6% [1,5,13,30,44,61,70]. Seizures are also frequent in PLE [26,30,67].…”

Section: Seizuresmentioning

confidence: 99%

“…This tremor is often mild and generalized, developing shortly after CsA therapy is initiated [31,36,44,47,49]. Intention tremor, as part of a cerebellar syndrome is less frequent [2,59,66].…”

Section: Tremormentioning

confidence: 99%

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Cyclosporine neurotoxicity: a review

Gijtenbeek

Bent

Vecht

1999

Journal of Neurology

379

287

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Cyclosporin A (CsA) induces neurological side effects in up to 40% of patients. A reversible posterior leukoencephalopathy syndrome is the most serious complication. Symptoms include headache, altered mental functioning, seizures, cortical blindness, and other visual disturbances, with hypertension. Neuroimaging studies show white matter changes in the posterior regions of the brain. Other neurological side effects of CsA include tremor, diffuse encephalopathy, cerebellar syndrome, extrapyramidal syndrome, pyramidal weakness, and peripheral neuropathy. Hypertension, hypomagnesemia, hypocholesteremia, and the vasoactive agent endothelin may all play a role in the pathogenesis of CsA neurotoxicty. Neurotoxicity is more frequent with high CsA blood levels, but levels may be within the therapeutic range. Dose reduction or withdrawal of CsA usually results in resolution of clinical symptoms and of neuroimaging abnormalities.

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Section: Tremormentioning

confidence: 99%

“…Large series reported an incidence of CsA-related seizures of 1.5-6% [1,5,13,30,44,61,70]. Seizures are also frequent in PLE [26,30,67].…”

Section: Seizuresmentioning

confidence: 99%

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Cyclosporine neurotoxicity: a review

Gijtenbeek

Bent

Vecht

1999

Journal of Neurology

379

287

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“…Use of CyA for immunosuppres sion is associated with multiple side effects. Overall, ap proximately 20% of patients receiving CyA will develop tremors and 10% seizures [2], One report estimates that 5% of bone marrow transplant patients and 1.5% of kidney transplant patients develop seizures [3]. Recently, several transplant centers have reported neurotoxicity in over 25% of patients after liver transplantation [4][5][6], The re ported CyA-induced seizures occurred exclusively in or gan transplant patients.…”

Section: Discussionmentioning

confidence: 99%

Ketoconazole and High-Dose Methylprednisolone Predisposing to Cyclosporine-lnduced Seizures: Report of 3 Cases

Hwang

Young²,

Chia³

1992

Acta Haematol

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Three consecutive cases of severe aplastic anemia undergoing immunosuppressive therapy with cyclosporin A (CyA) and high-dose methylprednisolone (HDMP) developed grand mal seizures after receiving ketoconazole treatment. All the seizures were reversed after transient discontinuation of those drugs. To our knowledge, it has not been reported as yet that the combination of ketoconazole and HDMP may considerably increase the risk of CyA-in-duced seizure. We would advise that ketoconazole and HDMP not be taken concomitantly with CyA treatment, and whenever ketoconazole therapy is needed, CyA be started with as small a dose as possible.

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“…

Dear Sir, Ciclosporin A (CS) associated central nervous system toxicity was first described in 1982 [1], Since then, reports have increased to such an extent that convulsions are considered to be present in 1.5% of recipients of renal transplants who were treated with this drug [2], The clinical picture of this neurotoxicity varies greatly and includes convulsions, paresthesia, motor spinal cord syn drome, cerebellar-like syndrome, tremors, aphasia, de pression, and other signs of mental disturbance. These symptoms may be severe and may be a cause of death [3], While all the cases described to date recovered com pletely following CS withdrawal, symptoms reappeared after its reintroduction [4], We report on a case of dementia following an episode of convulsions in a renal transplant under CS which still persists 26 months after discontinuation of the drug.

This 31 -year-old man had a history of poliomyelitis at the age of 3 years, with residual paralysis of the lower limbs.

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mentioning

confidence: 99%