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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 - 1996
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.1600-0404.1996.tb07081.x
Subject(s) - medicine , discontinuation , toxicity , cortical blindness , somatosensory evoked potential , 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.