Cyclosporine neurotoxicity: a review

被引:319
作者
Gijtenbeek, JMM
van den Bent, MJ
Vecht, CJ
机构
[1] Dr Daniel Den Hoed Canc Ctr, Dept Neurooncol, NL-3008 AE Rotterdam, Netherlands
[2] Westeinde Ziekenhuis, Dept Neurol, Med Ctr Haaglanden, NL-2501 CK The Hague, Netherlands
关键词
cyclosporine neurotoxicity; reversible posterior leukoencephalopathy hypomagnesemia; hypocholesterolemia; endothelin;
D O I
10.1007/s004150050360
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
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 syn drome, 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.
引用
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页码:339 / 346
页数:8
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