Calcineurin-inhibitor neurotoxicity: clinical features

Evidence-based neurology checklist on calcineurin-inhibitor neurotoxicity: clinical features: Posterior reversible encephalopathy syndrome (PRES) This has a parieto-occipital distribution The CSF is normal or protein may be a mildly increased The EEG shows non-specific encephalopathy…

Posterior reversible encephalopathy syndrome (PRES)

  • This has a parieto-occipital distribution
  • The CSF is normal or protein may be a mildly increased
  • The EEG shows non-specific encephalopathy
  • Leukoencephalopathy may be delayed
  • It may be isolated to the brain stem: rhombencephalitis
  • Reversibility may be incomplete

PRES-related intracranial haemorrhage

Demyelination

Psychiatric features

Movement disorders

Other central features

Peripheral neuropathy (PN)

Other peripheral nerve features

References

  1. Pruitt AA, Graus F, Rosenfeld MR. Neurological complications of solid organ transplantation. Neurohospitalist 2013; 3:152-166. 
  2. Senzolo M, Ferronato C, Burra P. Neurologic complications after solid organ transplantation. Transpl Int 2009; 22:269-278.
  3. Chang GY, Saadi A, Schmahmann JD. Pearls & Oy-sters: Tacrolimus neurotoxicity presenting as an isolated brainstem lesion. Neurology 2016; 87:1423. 
  4. Chegounchi M, Hanna MG, Neild GH. Progressive neurological disease induced by tacrolimus in a renal transplant recipient: case presentation. BMC Nephrol 2006; 7:7.
  5. Barragán-Martínez D, Simarro-Díaz A, Calleja-Castaño P, Hernández-Laín A, Ramos-González A, Villarejo-Galende A. Delayed tacrolimus leukoencephalopathy, a rare and reversible cause of dementia. Neurol Neuroimmunol Neuroinflamm 2017; 4:e319. 
  6. And 21 more. Subscribe to see the full list

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