Nervous system effects of antituberculosis therapy.

Area of Science:

• Pharmacology
• Neurology
• Infectious Diseases

Background:

• Antituberculosis pharmacotherapy is essential but can lead to nervous system toxicity.
• Physicians must be aware of potential central and peripheral nervous system effects impacting patient compliance.

Purpose of the Study:

• To review the neurotoxicity associated with current antituberculosis therapies.
• To highlight specific agents and their associated neurological adverse events.
• To discuss future needs for surveillance and risk identification.

Main Methods:

• Literature review of neurotoxicity from antituberculosis drugs.
• Analysis of adverse events associated with first-line and second-line agents.
• Discussion of emerging therapies and future research directions.

Main Results:

• Isoniazid is linked to peripheral neuropathy, psychosis, and seizures.
• Ethambutol can cause optic neuropathy; aminoglycosides may lead to ototoxicity and neuromuscular blockade.
• Cycloserine is associated with psychosis and seizures, while fluoroquinolones can rarely cause seizures and delirium.

Conclusions:

• Nervous system toxicity from antituberculosis drugs, though uncommon, requires physician awareness.
• Development of surveillance mechanisms and pharmacogenomic assays is needed to identify at-risk patients and improve management.