NEUROLOGICAL COMPLICATIONS FOLLOWING LIVER-TRANSPLANTATION

被引:109
作者
STEIN, DP
LEDERMAN, RJ
VOGT, DP
CAREY, WD
BROUGHAN, TA
机构
[1] CLEVELAND CLIN EDUC FDN,DEPT NEUROL,CLEVELAND,OH 44106
[2] CLEVELAND CLIN EDUC FDN,DEPT GEN SURG,CLEVELAND,OH 44106
[3] CLEVELAND CLIN EDUC FDN,DEPT GASTROENTEROL,CLEVELAND,OH 44106
关键词
D O I
10.1002/ana.410310612
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Neurological complications occurred in 4 (19%) of 21 consecutive patients (Group II) undergoing orthotopic liver transplantation, compared with a 47% (9/19) incidence in our initial series (Group I). In Group 11, the neurological problems included new recurrent headaches and delayed intracerebral hemorrhage (1 patient), partial third nerve palsy and brachial plexopathy (I patient), and ataxic dysarthria with encephalopathy (2 patients). Seizures, noted in 8 of 9 neurologically affected Group I patients, were not encountered in Group II. Of the 4 patients in the entire series with the cerebrocerebellar syndrome, 2 had partial recovery after stopping treatment with cyclosporine, 1 stabilized when cyclosporine was discontinued but later worsened when rechallenged, and 1 had full recovery but died following a second transplantation. Brain magnetic resonance images appeared normal in 3 of the 4 patients. Complications affecting vision included cortical blindness in 2 patients and occipital lobe hemorrhage in 1. All completely recovered. Survival was comparable for patients with and those without neurological complications (69% and 63%, respectively). Immediate withdrawal of cyclosporine at the onset of a change in mental status or dysarthria and improvement in intra- and postoperative management may have contributed to the decreased incidence of neurological complications.
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页码:644 / 649
页数:6
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