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Acute isoniazid neurotoxicity during preventive therapy
I Martinjak-Dvorsek1, V Gorjup, M Horvat
1Center for Intensive Internal Medicine, University Medical Center, Ljubljana, Slovenia-Europe.
Critical Care Medicine
|March 9, 2000
Summary
Isoniazid preventive therapy can cause rare neurotoxicity, including seizures and coma, in healthy individuals. Prompt treatment with pyridoxine is crucial for recovery.
Area of Science:
- Neuroscience
- Pharmacology
- Public Health
Background:
- Isoniazid is a primary agent for tuberculosis prevention.
- Adverse effects are typically monitored, but rare toxicities require documentation.
Observation:
- A previously healthy 14-year-old girl developed seizures and coma during isoniazid preventive therapy.
- No overdose was confirmed, and initial neurological imaging was unremarkable.
Findings:
- Generalized tonic-clonic seizures resolved within 2 hours after sedation and intravenous pyridoxine administration.
- The patient recovered fully without sequelae after discontinuing isoniazid.
Implications:
- This case highlights the potential for isoniazid-induced neurotoxicity even at recommended doses.
- Clinicians should consider neurotoxicity in patients presenting with neurological symptoms during isoniazid therapy.
- Pyridoxine administration is a key intervention for managing isoniazid neurotoxicity.