Eye movement disorders in bone marrow transplant patients on cyclosporin and ganciclovir.
After 582 allogeneic bone marrow transplants, we have encountered four patients (0.7%) who developed transient unilateral or bilateral sixth nerve palsies. Three of the four patients also had bilateral ptosis. These signs resolved 24-48 h after cyclosporin and ganciclovir were discontinued. One patient had MRI T2 abnormalities compatible with cyclosporin neurotoxicity. We postulate that cyclosporin, possibly together with ganciclovir, can produce transient brain stem or neuromuscular dysfunction with eye movement abnormality in occasional patients.
Openshaw
H
H
Department of Neurology, City of Hope National Medical Center, Duarte, CA, USA.
Slatkin
N E
NE
Smith
E
E
D000010:Abducens Nerve; D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000009:adverse effects*; D001763:Blepharoptosis / Q000139:chemically induced*; D016026:Bone Marrow Transplantation; D003389:Cranial Nerve Diseases / Q000139:chemically induced; D016572:Cyclosporine / Q000009:adverse effects*; D003586:Cytomegalovirus Infections / Q000188:drug therapy; D004172:Diplopia / Q000139:chemically induced; D005260:Female; D015774:Ganciclovir / Q000009:adverse effects*; D006086:Graft vs Host Disease / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D007938:Leukemia / Q000628:therapy; D008297:Male; D009886:Ophthalmoplegia / Q000139:chemically induced*; D014766:Viremia / Q000188:drug therapy
D000998:Antiviral Agents; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D015774:Ganciclovir