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Efavirenz as a cause of ataxia in children

M P K Hauptfleisch, D P Moore, J L Rodda

    South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde
    |December 5, 2015
    PubMed

    Insights

    Efavirenz toxicity can cause acute ataxia in children with HIV. This highlights the importance of considering medication side effects in pediatric patients presenting with walking unsteadiness.

    Area of Science:

    • Neurology
    • Pediatrics
    • Infectious Diseases

    Background:

    • Acute ataxia in children is commonly linked to toxin ingestion or post-infectious causes.
    • Neurological complications are frequent in HIV-positive children, though cerebellar dysfunction is rarely documented.
    • Ataxia in HIV is typically secondary to opportunistic infections, vascular issues, or neoplastic lesions.

    Purpose of the Study:

    • To report two cases of acute ataxia in pediatric patients with HIV.
    • To highlight efavirenz toxicity as a potential cause of ataxia in this population.
    • To emphasize the need to consider medication side effects in the differential diagnosis of pediatric ataxia.

    Main Methods:

    • Case report of two pediatric patients presenting with acute ataxia.
    • Review of clinical presentation, medical history, and neurological examination findings.
    • Assessment of potential causes including infections, mass lesions, and medication toxicity.

    Main Results:

    • Both patients presented with acute ataxia, a rare neurological complication.
    • Efavirenz toxicity was identified as the cause of ataxia in both cases.
    • The cases occurred within a one-month period, suggesting a potential emerging issue.

    Conclusions:

    • Efavirenz toxicity is an important differential diagnosis for acute ataxia in HIV-positive children.
    • Clinicians should consider antiretroviral medication side effects when evaluating pediatric ataxia.
    • Further investigation into the neurological side effects of efavirenz in children is warranted.

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