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Seizures associated with ganciclovir therapy.

T L Barton1, M K Roush, L L Dever

  • 1Department of Pharmacology, University of Texas Health Science Center, San Antonio 78284-7766.

Pharmacotherapy
|January 1, 1992
PubMed
Summary

Ganciclovir, an antiviral medication, may cause seizures in patients with acquired immunodeficiency syndrome (AIDS) and cytomegalovirus (CMV) infections. Discontinuation of ganciclovir led to seizure resolution, with recurrence upon reintroduction, suggesting a probable link.

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Area of Science:

  • Neuroscience
  • Infectious Diseases
  • Pharmacology

Background:

  • Cytomegalovirus (CMV) infections are common opportunistic infections in patients with acquired immunodeficiency syndrome (AIDS).
  • Ganciclovir is a primary antiviral agent used to treat CMV infections in immunocompromised individuals.

Observation:

  • A case study involving a 32-year-old male with AIDS and disseminated CMV infection is presented.
  • The patient experienced seizure activity that correlated with the initiation and dosage escalation of ganciclovir therapy.

Findings:

  • Seizure-like activity commenced one month after starting ganciclovir and intensified with increased doses.
  • Phenytoin, an anticonvulsant, failed to fully control the seizures, which resolved only after ganciclovir discontinuation.

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  • Recurrence of seizures was observed upon ganciclovir rechallenge, supporting a probable association.

    • Implications:

    • This case highlights a potential neurotoxic side effect of ganciclovir, specifically seizure induction.
    • Clinicians should consider ganciclovir-induced seizures in immunocompromised patients presenting with neurological symptoms.
    • Further investigation into the mechanisms of ganciclovir neurotoxicity is warranted.