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Neurophysiologic evaluation of cyclosporine toxicity associated with bone marrow transplantation
Author(s) -
Edwards L. L.,
Wszolek Z. K.,
Normand M. M.
Publication year - 1995
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/j.1600-0404.1995.tb00158.x
Subject(s) - medicine , discontinuation , toxicity , somatosensory evoked potential , cortical blindness , neurotoxicity , white matter , anesthesia , transplantation , surgery , magnetic resonance imaging , blindness , radiology , optometry
– Cortical blindness, a rare form of cyclosporine (CSA) neurotoxicity, has previously been described in only nine bone marrow transplant (BMT) recipients. Methods ‐ Our institution averages 35 allogeneic BMT's per year. In the past year we have seen two women with reversible cortical blindness secondary to CSA toxicity. Results ‐ Age (years) (Case 1; Case 2): 32; 22. Day post‐BMT: 41; 50. Peak CSA level (ng/ml): 1159; 632. Both had a history of renal toxicity requiring adjustment of CSA dosage. MRI ‐ both with diffuse white matter changes. EEG‐both with moderate to severe generalized slowing. Visual evoked potentials were markedly prolonged in both. Auditory evoked potentials: minimally abnormal; normal. Somatosensory evoked potentials ‐ both normal. Prompt improvement occurred with discontinuation of CSA. Followup neurophysiologic evaluations were normal, however structural changes remained on MRI. Conclusion ‐ As neurophysiologic studies closely follow the clinical status they should be included in the evaluation and followup of CSA neurotoxicity.