Sueiras M, González N, Rovira R, Padró L
Servicio de Neurologia, Sección de Neurofisiología Clínica. Hospital Creu Roja de Barcelona, España.
Rev Neurol. 1998 May;26(153):766-9.
Cyclosporine A is one of the immunosuppressors most frequently used to prevent transplant rejection. Neurotoxicity is one of the complications often associated with it. These complications include acute encephalopathy, lethargy, confusion state, tremor, headache, motor disorders, visual changes and epileptic crises amongst others, even when blood levels are at what are considered to be 'therapeutic' levels.
We present the EEG anomalies found in 3 transplant patients (two liver transplants and on double lung transplant) to whom cyclosporin A had been given and who presented with status epilepticus. The EEG recordings showed paroxystic discharges of focal onset in the temporo-occipital areas. They were mainly correlated with the clinical findings of oculomotor and eyelid disorders.
The topography of the neurophysiological findings supports--as do the other clinico-radiological findings--localization preferably to the posterior areas of cerebral dysfunction associated with cyclosporin A. Although the physiopathological origin of the encephalopathy of patients treated with cyclosporin A seems to correspond to multiple factors, we wish to point out the diagnostic usefulness of the identification of EEG changes localized to the temporo-occipital areas in the recognition of the neurotoxic syndrome in these patients.
环孢素A是预防移植排斥反应最常用的免疫抑制剂之一。神经毒性是其常见并发症之一。这些并发症包括急性脑病、嗜睡、意识模糊状态、震颤、头痛、运动障碍、视觉改变和癫痫发作等，即使血药浓度处于所谓的“治疗”水平时也会出现。
我们展示了3例接受环孢素A治疗并出现癫痫持续状态的移植患者（2例肝移植和1例双肺移植）的脑电图异常情况。脑电图记录显示颞枕区局灶性发作的阵发性放电。它们主要与眼球运动和眼睑障碍的临床发现相关。
神经生理学发现的部位——与其他临床放射学发现一样——支持将与环孢素A相关的脑功能障碍定位在大脑后部区域。尽管接受环孢素A治疗的患者脑病的生理病理起源似乎对应多种因素，但我们希望指出，识别颞枕区脑电图变化对诊断这些患者的神经毒性综合征具有重要作用。
