Cyclosporin A toxicity: MRI appearance of the brain

Neurotoxicity is a recognized complication with the use of Cyclosporin A (CSA) in bone marrow and organ transplantation patients. Most common symptoms are seizures and altered mental status which are usually transient. We report three cases of transient neurotoxic episodes in patients receiving CSA after a bone marrow transplant. There were reversible low-attenuation changes on CT and bright T2-weighted signal changes on MRI in the cortex and/or white matter of the cerebral hemispheres. All three patients, when given lower maintenance doses of CSA, were free of recurrent neurotoxic effects.