Visual hallucinations at the onset of tolterodine treatment in a patient with a high‐level spinal cord injury

Abstract

with the use of sympathomimetics such as ephedrine in Case reportnasal decongestants, or herbal stimulants and betaagonists in asthma. We therefore propose that autonomic A 46-year-old paraplegic woman had suCered a spinal cord injury (level of injury T6-T7) 19 years earlier and hyper-reflexia and treatment with muscarinic receptor antagonists may result in visual hallucinations, and we was using CISC; however, this became unsatisfactory after an abdominal hysterectomy. Tolterodine (2 mg suggest caution at the onset of tolterodine treatment in patients with a high-level spinal cord injury. twice daily) was given to increase the functional bladder capacity. Four days later she complained of seeing snakes; visual hallucinations persisted for the duration of the treatment (5 days) and subsided within 3 days of disconReferences tinuing tolterodine.

Pharmacologic treatment for detrusor overactivity

“…No serious adverse cardiac event attributed directly to tolterodine use has been documented in any of more than a few dozen well-conducted clinical trials. Overall, central nervous system (CNS) side effects from tolterodine are rare [19,33]. Unlike immediaterelease oxybutynin and its major metabolite (N-desethyloxybutynin), which cross the blood-brain barrier and theoretically may cause CNS adverse effects such as somnolence and cognitive impairment [34•], tolterodine has lower lipophilicity and therefore, probably less penetration into the CNS [35,36].…”