Cyclosporine neurotoxicity: A review

J. M.M. Gijtenbeek, M. J. Van Den Bent, Ch J. Vecht*

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

395 Citations (Scopus)


Cyclosporin A (CsA) induces neurological side effects in up to 40% of patients. A reversible posterior leukoencephalopathy syndrome is the most serious complication. Symptoms include headache, altered mental functioning, seizures, cortical blindness, and other visual disturbances, with hypertension. Neuroimaging studies show white matter changes in the posterior regions of the brain. Other neurological side effects of CsA include tremor, diffuse encephalopathy, cerebellar syndrome, extrapyramidal syndrome, pyramidal weakness, and peripheral neuropathy. Hypertension, hypomagnesemia, hypocholesteremia, and the vasoactive agent endothelin may all play a role in the pathogenesis of CsA neurotoxicty. Neurotoxicity is more frequent with high CsA blood levels, but levels may be within the therapeutic range. Dose reduction or withdrawal of CsA usually results in resolution of clinical symptoms and of neuroimaging abnormalities.

Original languageEnglish
Pages (from-to)339-346
Number of pages8
JournalJournal of Neurology
Issue number5
Publication statusPublished - May 1999


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