acyclovir and Dementia--Vascular

We report the case of a 43-year-old man who developed an acute encephalopathy after IVIg therapy for AIDP. Imaging studies showed predominantly posterior leukoencephalopathy. The signs and symptoms of the encephalopathy completely resolved by steroids. Two patients with acute encephalopathy, following IVIg therapy, were reported previously in the literature. However, our observation differed from them by the presence of a marked pleiocytosis of cephalospinal fluid before beginning of IgIV. Two hypothesis may be made: a post-infectious meningo-encephalo-AIDP or a complication of IgIV. This side effect, even rare, has not to be underestimated.

Topics: Acute Disease; Acyclovir; Adult; Anti-Inflammatory Agents; Antiviral Agents; Brain; Ceftriaxone; Cephalosporins; Dementia, Vascular; Drug Therapy, Combination; Humans; Immunoglobulins, Intravenous; Magnetic Resonance Imaging; Male; Polyradiculoneuropathy; Steroids

In differential diagnosis of a delir also adverse effects of medicaments have to be taken into account beside other causes. We report a case of an agitated delir with nocturnal disturbance of consciousness, confusion, restlessness and sleeplessness. This delir existed exclusively during the therapy of a cutaneous herpes zoster with zovirax-pills which can only be explained by a causal connection--after exclusion of other causes. As a so far undescribed predisposition for neurotoxicity of oral therapy with acyclovir signs of vascular encephalopathy were found in the patient's cranial magnetic resonance imaging. The central nervous side effects of acyclovir were summarized shortly.

Topics: Acyclovir; Aged; Antiviral Agents; Brain; Delirium; Dementia, Vascular; Diagnosis, Differential; Herpes Zoster; Humans; Magnetic Resonance Imaging; Male; Psychoses, Substance-Induced