acyclovir and Tremor

Despite the lack of virus-specified thymidine kinase activity, human cytomegalovirus may be sensitive to acyclovir in vitro at concentrations between 10 and 25 mg/l. The inhibitory effect of acyclovir can be further increased by the presence of small amounts of human alpha or beta interferon. Twenty-one allogeneic marrow graft recipients with biopsy-proven cytomegalovirus pneumonia were treated with either high doses of acyclovir (eight patients) or the combination of acyclovir and human alpha (leukocyte) interferon (13 patients). Acyclovir doses of 400 to 1200 mg/m2/dose and interferon doses of 2 to 40 X 10(4) units/kg/day were used. There was no consistent effect of treatment on the likelihood or duration of survival, titre of virus in paired lung specimens, or shedding of virus. However, four patients survived and four others had 2-log or greater decreases in the amount of virus in paired lung specimens, suggesting a possible effect on cytomegalovirus strains with increased sensitivity to these agents. Acyclovir treatment of cytomegalovirus infection may be more effective in patients with lesser degrees of immunosuppression, but was not effective in the treatment of marrow transplant patients with cytomegalovirus pneumonia.

Topics: Acyclovir; Bone Marrow; Bone Marrow Transplantation; Combined Modality Therapy; Cytomegalovirus Infections; Humans; Immunosuppression Therapy; Interferon Type I; Kidney; Leukemia; Pneumonia, Viral; Tremor

Despite the lack of virus-specified thymidine kinase activity, human cytomegalovirus may be sensitive to acyclovir in vitro at concentrations between 10 and 25 mg/l. The inhibitory effect of acyclovir can be further increased by the presence of small amounts of human alpha or beta interferon. Twenty-one allogeneic marrow graft recipients with biopsy-proven cytomegalovirus pneumonia were treated with either high doses of acyclovir (eight patients) or the combination of acyclovir and human alpha (leukocyte) interferon (13 patients). Acyclovir doses of 400 to 1200 mg/m2/dose and interferon doses of 2 to 40 X 10(4) units/kg/day were used. There was no consistent effect of treatment on the likelihood or duration of survival, titre of virus in paired lung specimens, or shedding of virus. However, four patients survived and four others had 2-log or greater decreases in the amount of virus in paired lung specimens, suggesting a possible effect on cytomegalovirus strains with increased sensitivity to these agents. Acyclovir treatment of cytomegalovirus infection may be more effective in patients with lesser degrees of immunosuppression, but was not effective in the treatment of marrow transplant patients with cytomegalovirus pneumonia.

Topics: Acyclovir; Bone Marrow; Bone Marrow Transplantation; Combined Modality Therapy; Cytomegalovirus Infections; Humans; Immunosuppression Therapy; Interferon Type I; Kidney; Leukemia; Pneumonia, Viral; Tremor

Dizziness and ataxia are known adverse effects of pregabalin, but characteristic oculomotor signs in pregabalin intoxication have not been reported. Here we describe a patient who displayed perverted head-shaking and positional downbeat nystagmus after prescription of a high dosage of pregabalin. Since pregabalin reduces excitatory neurotransmitter secretion in the central nervous system, decreased excitatory inputs from the brainstem may lead to cerebellar dysfunction, causing perverted head-shaking and positional downbeat nystagmus.

Topics: Acyclovir; Aged; Anticonvulsants; Antiviral Agents; Dizziness; Female; gamma-Aminobutyric Acid; Head Movements; Humans; Nystagmus, Pathologic; Pregabalin; Tremor; Vertigo

Topics: Acyclovir; Akathisia, Drug-Induced; Baclofen; Continuity of Patient Care; Humans; Kidney Failure, Chronic; Male; Muscle Relaxants, Central; Myoclonus; Renal Dialysis; Tremor

Topics: Acyclovir; Aged; Akathisia, Drug-Induced; Alcoholic Intoxication; Baclofen; Continuity of Patient Care; Diagnostic Errors; Drug Overdose; Emergencies; Herpes Zoster; Humans; Kidney Failure, Chronic; Male; Muscle Relaxants, Central; Myoclonus; Poisoning; Renal Dialysis; Tremor; Uremia

Since the outbreak of novel influenza A (H1N1) in 2009, various neurological complications have been cited. We described a male patient with H1N1-associated encephalopathy/encephalitis presenting with severe neurological symptoms and signs. Residual neurological sequelae were dominant. This is the first report of extensive cortical-subcortical necroses over the bilateral frontal-parietal areas based on an MRI study.

Topics: Acyclovir; Adult; Anti-Bacterial Agents; Antiviral Agents; Brain; Cerebral Angiography; Electroencephalography; Encephalitis; Hemiplegia; Humans; Hypnotics and Sedatives; Influenza A Virus, H1N1 Subtype; Influenza, Human; Magnetic Resonance Angiography; Magnetic Resonance Imaging; Male; Muscle Rigidity; Nervous System Diseases; Oseltamivir; Propofol; Tomography, X-Ray Computed; Tremor

Topics: Acyclovir; Anticonvulsants; Antiviral Agents; Central Nervous System Viral Diseases; Clonazepam; Combined Modality Therapy; Herpes Simplex; Herpesvirus 1, Human; Humans; Magnetic Resonance Imaging; Male; Mesencephalon; Middle Aged; Severity of Illness Index; Tremor

Topics: Acyclovir; Aged; Antiviral Agents; Brain; Confusion; Hallucinations; Herpes Zoster; Humans; Male; Tremor

Six marrow transplant recipients receiving acyclovir at various dosages for herpesvirus infections developed neurologic symptoms during treatment. Three were receiving concomitant human alpha interferon, and all six had received previous intrathecal methotrexate. Symptoms developed a median of 8 days (range, 2 to 18 days) after initiation of therapy and consisted of lethargy or agitation in five patients, tremor in five, and disorientation or transient hemiparesthesias in one patient each. The only consistent laboratory finding was an abnormal electroencephalogram. Five patients had an increased myelin basic protein level in cerebrospinal fluid. Improvement or resolution of symptoms occurred a median of 13 days (range, 4 to 15 days) after cessation of acyclovir therapy. Acyclovir used at a wide range of dosages may be associated with reversible neurologic symptoms in patients after marrow transplantation. The contribution of previous prophylaxis for central nervous system leukemia, herpesvirus infections, marrow transplantation, or the concomitant use of interferon is unknown.

Topics: Acyclovir; Adolescent; Adult; Akathisia, Drug-Induced; Bone Marrow Transplantation; Child; Electroencephalography; Female; Herpesviridae Infections; Humans; Male; Nervous System Diseases; Paresthesia; Postoperative Complications; Tremor