Movement disorders secondary to long-term treatment with cyclosporine A.
OBJECTIVE
To analyze the prevalence, severity and functional interference of movement disorders (MD) secondary to chronic use of cyclosporine A (CsA).


METHODS
We conducted a cross-sectional study of 60 patients (58.3% male) with mean age 23.1 (3-75) years, followed at the Bone Marrow Transplantation Service of the Hospital de Clínicas of the Federal University of Paraná, Brazil, taking CsA for at least six months. Our protocol included clinical data, assessment of functional interference of symptoms and neurological examination including observation and grading of MD.


RESULTS
Eight (13.3%) subjects reported the presence of tremor at the moment of interview and 29 (48.3%) recalled this symptom at some point during treatment. Neurological examination identified 14 (23.3%) subjects with MD: upper limb symmetric action tremor in 13 (21.6%) and parkinsonism (rigidity and bradykinesia) in 1 (1.7%). No other MD was detected. The mean scores indicated mild clinical signs in all cases. Symptoms were considered subjectively mild with no functional interference.


CONCLUSIONS
Almost one quarter of patients using CsA chronically presented MD, almost always mild and transitory action tremor, with minimal interference on daily living activities, not requiring any form of intervention in the majority of cases.
Munhoz
Renato P
RP
Neurology Service, Hospital de Clínicas, Federal University of Paraná, Curitiba, PR, Brazil.
Teive
Helio A G
HA
Germiniani
Francisco M B
FM
Gerytch
Júlio C
JC
Sá
Daniel S
DS
Bittencourt
Marco A
MA
Pasquini
Ricardo
R
Camargo
Carlos H F
CH
Werneck
Lineu César
LC
D000328:Adult; D000368:Aged; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D016572:Cyclosporine / Q000009:adverse effects* / Q000627:therapeutic use; D004409:Dyskinesia, Drug-Induced / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D007407:Interviews as Topic; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D015995:Prevalence; D012720:Severity of Illness Index
D007166:Immunosuppressive Agents; D016572:Cyclosporine