Calcineurin-inhibitor neurotoxicity: clinical features
Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .
Calcineurin-inhibitor neurotoxicity: clinical features. This has a parieto-occipital distribution. Fully referenced neurology checklist.
Posterior reversible encephalopathy syndrome (PRES)
- This has a parieto-occipital distribution
- The CSF is normal or protein may be a mildly increased
- The EEG shows non-specific encephalopathy
- Leukoencephalopathy may be delayed
- It may be isolated to the brain stem: rhombencephalitis
- Reversibility may be incomplete
PRES-related intracranial haemorrhage
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Demyelination
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Psychiatric features
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Movement disorders
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Other central features
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Peripheral neuropathy (PN)
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Other peripheral nerve features
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References
- Pruitt AA, Graus F, Rosenfeld MR. Neurological complications of solid organ transplantation. Neurohospitalist 2013; 3:152-166.
- Senzolo M, Ferronato C, Burra P. Neurologic complications after solid organ transplantation. Transpl Int 2009; 22:269-278.
- Chang GY, Saadi A, Schmahmann JD. Pearls & Oy-sters: Tacrolimus neurotoxicity presenting as an isolated brainstem lesion. Neurology 2016; 87:1423.
- Chegounchi M, Hanna MG, Neild GH. Progressive neurological disease induced by tacrolimus in a renal transplant recipient: case presentation. BMC Nephrol 2006; 7:7.
- Barragán-Martínez D, Simarro-Díaz A, Calleja-Castaño P, Hernández-Laín A, Ramos-González A, Villarejo-Galende A. Delayed tacrolimus leukoencephalopathy, a rare and reversible cause of dementia. Neurol Neuroimmunol Neuroinflamm 2017; 4:e319.
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