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Reversible brain MRI changes in acyclovir neurotoxicity

M E Blohm1, W Nürnberger, A Aulich

  • 1Department of Paediatric Haematology and Oncology, Heinrich Heine University Medical Centre, Dusseldorf, Germany.

Bone Marrow Transplantation
|May 1, 1997
PubMed
Summary
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Acyclovir toxicity can cause reversible brain MRI changes, including seizures, in pediatric patients. Neuroimaging findings resolved after discontinuing the antiviral medication.

Area of Science:

  • Neurology
  • Radiology
  • Pharmacology

Background:

  • Acyclovir is a commonly used antiviral medication.
  • Neurotoxicity is a potential adverse effect of acyclovir.
  • Previous neuroimaging studies in acyclovir toxicity have yielded limited or inconclusive results.

Observation:

  • A 12-year-old girl developed seizures after receiving prophylactic intravenous acyclovir post-stem cell transplantation.
  • Cerebral Magnetic Resonance Imaging (MRI) revealed multiple areas of gadolinium enhancement and blood-brain barrier disruption.
  • Infectious etiologies for the neurological symptoms were ruled out.

Findings:

  • The observed brain MRI changes were likely attributable to acyclovir toxicity.
  • The patient's clinical symptoms and MRI abnormalities resolved completely within 9 days of acyclovir cessation.

Related Experiment Videos

  • This case highlights the potential for acyclovir to induce significant, yet reversible, central nervous system pathology.
  • Implications:

    • This case provides crucial evidence of characteristic neuroimaging findings in acyclovir toxicity.
    • It underscores the importance of considering acyclovir-induced neurotoxicity in patients presenting with neurological symptoms.
    • The findings suggest that prompt discontinuation of acyclovir can lead to complete recovery from associated neurological deficits and imaging abnormalities.