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Local Anesthetics: Adverse Effects

Local Anesthetics: Adverse Effects

While local anesthetics are generally safe and well-tolerated, they can occasionally cause adverse effects that vary in severity. Local anesthetics can induce toxicity at two distinct levels. They can either produce local effects through direct contact with the neural elements or be absorbed into the bloodstream from the injection site, leading to systemic effects.
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...

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Induction of Leptomeningeal Cells Modification Via Intracisternal Injection

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Published on: May 7, 2020

Amphotericin B-associated leukoencephalopathy.

R W Walker¹, M K Rosenblum

¹Department of Neurology, Sloan-Kettering Cancer Center, New York, NY 10021.

|October 1, 1992

Summary

This summary is machine-generated.

Fatal leukoencephalopathy, a severe brain condition, occurred in two young patients treated with antifungal agent amphotericin B (AmB). This suggests AmB may be a potential leukotoxin, especially when combined with cranial irradiation.

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Isolation of Brain-infiltrating Leukocytes

Isolation of Brain-infiltrating Leukocytes

Published on: June 13, 2011

Area of Science:

Neuroscience
Toxicology
Oncology

Background:

Antifungal agents are crucial in treating invasive fungal infections, particularly in immunocompromised patients.
Amphotericin B (AmB) is a potent polyene macrolide antibiotic widely used for systemic fungal infections.
Leukoencephalopathy is a rare but serious neurological complication that can arise from various treatments.

Purpose of the Study:

To report and characterize fatal leukoencephalopathy in patients treated with amphotericin B (AmB).
To investigate the potential neurotoxicity of AmB, particularly in combination with cranial irradiation.
To review existing evidence on polyene macrolide antibiotics as potential leukotoxins.

Main Methods:

Case report of two patients (16-year-old female, 22-year-old male) with hematological malignancies.
Detailed clinical, neuroimaging (CT, MRI), and postmortem examination findings.
Literature review on amphotericin B and leukoencephalopathy.

Main Results:

Both patients developed a subacute neurological disorder with personality changes, confusion, and akinetic mutism.
Neuroimaging revealed diffuse white matter abnormalities, particularly in the frontal lobes.
Postmortem analysis confirmed diffuse, noninflammatory leukoencephalopathy with astrogliosis, demyelination, and foamy macrophages, without evidence of infection or neoplasm.

Conclusions:

Intravenous amphotericin B (AmB), especially with cranial irradiation, may cause fatal leukoencephalopathy.
AmB should be considered a potential leukotoxin, necessitating careful monitoring in patients receiving this antifungal agent.
Further research is warranted to elucidate the mechanisms of AmB-induced neurotoxicity.