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Related Experiment Videos

Distinguishing acyclovir neurotoxicity from encephalomyelitis

S Rashiq1, L Briewa, M Mooney

  • 1Department of Medicine, St John Hospital and Medical Center, Detroit, Michigan.

Journal of Internal Medicine
|November 1, 1993
PubMed
Summary

Acyclovir neurotoxicity presents with confusion and lethargy, often in elderly patients with kidney issues. It is distinct from viral encephalitis by its rapid onset and lack of fever or focal neurological signs.

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Area of Science:

  • Neuroscience
  • Pharmacology
  • Infectious Disease

Background:

  • Acyclovir is a widely used antiviral medication.
  • Neurotoxicity is a potential adverse effect of many drugs.
  • Distinguishing drug-induced neurotoxicity from central nervous system infections is clinically important.

Observation:

  • This study analyzed 35 patients experiencing neuropsychiatric symptoms during acyclovir treatment.
  • Predisposing factors included concurrent neurotoxic medications and renal impairment.
  • Elevated acyclovir levels were frequently observed.

Findings:

  • Characteristic symptoms included confusion, agitation, lethargy, and hallucinations.
  • Fever, headache, seizures, and focal neurological deficits were rare.

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  • Cerebrospinal fluid and CT scans were typically normal, differentiating it from viral encephalitis.

    • Implications:

    • Acyclovir neurotoxicity is a dose-dependent, reversible condition.
    • Early recognition and discontinuation of acyclovir are crucial for patient recovery.
    • Understanding these clinical features aids in differentiating acyclovir neurotoxicity from viral encephalitis.