Valacyclovir neurotoxicity: clinical experience and review of the literature.
Valacyclovir (VACV) is used increasingly to treat herpes zoster, although neuropsychiatric symptoms [VACV neurotoxicity (VAN) or acyclovir neurotoxicity], may accompany use of this drug. To promote awareness of this rare condition, we describe here two clinical cases of VAN we previously reported and review 20 cases from the literature. In all cases, chronic or acute renal failure preceded VAN. The symptoms of VAN varied, but disturbances of consciousness and hallucination occurred most commonly. When acute renal failure was due to the drug, recovery from both the disturbance of consciousness and renal failure followed within several days after discontinuation of VACV. Early recognition and diagnosis will ensure effective treatment of VAN.
Asahi
T
T
Department of Crisis Medicine, Graduate School of Medicine, University of Toyama, Sugitani, Toyama, Japan. takashi-tym@umin.ac.jp
Tsutsui
M
M
Wakasugi
M
M
Tange
D
D
Takahashi
C
C
Tokui
K
K
Okazawa
S
S
Okudera
H
H
D058186:Acute Kidney Injury / Q000139:chemically induced*; D000212:Acyclovir / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003244:Consciousness Disorders / Q000139:chemically induced; D005260:Female; D006212:Hallucinations / Q000139:chemically induced; D006562:Herpes Zoster / Q000188:drug therapy; D006801:Humans; D007676:Kidney Failure, Chronic / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D020258:Neurotoxicity Syndromes / Q000175:diagnosis; D000077483:Valacyclovir; D014633:Valine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
D000998:Antiviral Agents; D014633:Valine; D000077483:Valacyclovir; D000212:Acyclovir