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Acetazolamide-induced Gerstmann syndrome.

Y T Lee1, J C Wu, F K Chan

  • 1Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong Kong, China.

International Journal of Clinical Practice
|February 29, 2000
PubMed
Summary
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Acetazolamide can cause acute confusion, especially in patients with kidney problems. This case highlights a rare instance of acetazolamide-induced Gerstmann syndrome in a patient with normal kidney function, revealing overlooked risk factors.

Area of Science:

  • Neurology
  • Pharmacology
  • Toxicology

Background:

  • Acetazolamide is a carbonic anhydrase inhibitor used to treat glaucoma, epilepsy, and altitude sickness.
  • Acute confusion is a recognized adverse drug reaction associated with acetazolamide, particularly in individuals with impaired renal function.
  • Gerstmann syndrome is a neurological disorder characterized by finger agnosia, agraphia, alexia, and left-right disorientation.

Observation:

  • A patient with normal renal function developed acute confusion after being prescribed acetazolamide.
  • The patient presented with symptoms consistent with Gerstmann syndrome.
  • Standard risk factors, such as renal impairment, were absent in this case.

Findings:

  • This case demonstrates that acetazolamide can induce Gerstmann syndrome even in patients with preserved kidney function.

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  • Predisposing factors beyond renal impairment may contribute to this adverse drug reaction.
  • The specific mechanisms underlying acetazolamide-induced neurological deficits require further investigation.

    • Implications:

    • Clinicians should consider acetazolamide as a potential cause of Gerstmann syndrome, irrespective of renal function.
    • Identifying and understanding overlooked predisposing factors is crucial for preventing acetazolamide-induced neurotoxicity.
    • This case underscores the importance of comprehensive patient evaluation to anticipate and mitigate adverse drug reactions.