piperidines and Papilledema

Central nervous system involvement from chronic lymphocytic leukemia (CLL) occurs infrequently, and manifestations include cognitive and cerebellar dysfunction and cranial nerve palsies. We report a 45-year-old man with CLL believed to be in clinical remission, who presented with vision loss and bilateral optic disc edema. His optic neuropathy due to CLL was proven by optic nerve sheath biopsy, and he experienced visual recovery after treatment with ibrutinib and intrathecal methotrexate.

Topics: Adenine; Antimetabolites, Antineoplastic; Biopsy; Drug Therapy, Combination; Humans; Leukemia, Lymphocytic, Chronic, B-Cell; Magnetic Resonance Imaging; Male; Methotrexate; Middle Aged; Optic Nerve; Papilledema; Piperidines; Pyrazoles; Pyrimidines; Spinal Puncture

Perhexiline maleate is an agent currently under investigation in Canada that is used for angina unresponsive to other treatment. This paper describes a possible side effect previously unreported--papilledema not associated with peripheral neuropathy.

Topics: Adult; Angina Pectoris; Fluorescein Angiography; Humans; Male; Papilledema; Perhexiline; Piperidines; Visual Fields

A patient developed papilloedema and hepatic dysfunction while being treated with perhexiline maleate. These later regressed when the drug was withdrawn. Patients should be monitored for these potentially serious side-effects while on this drug.

Topics: Angina Pectoris; Chemical and Drug Induced Liver Injury; Humans; Male; Middle Aged; Papilledema; Perhexiline; Piperidines

Topics: Adult; Angina Pectoris; Female; Humans; Intracranial Pressure; Male; Middle Aged; Papilledema; Perhexiline; Piperidines

Topics: Humans; Intracranial Pressure; Male; Middle Aged; Papilledema; Perhexiline; Piperidines

Topics: Cerebrospinal Fluid Proteins; Humans; Papilledema; Perhexiline; Piperidines

Topics: Aged; Coronary Disease; Female; Humans; Male; Middle Aged; Myocardial Infarction; Papilledema; Perhexiline; Piperidines

The authors report on a polyradiculoneuropathy related to long-term treatment with Perhexiline maleate (a drug used in France since 1973 for coronary insufficiency) whose presenting sign is a bilateral aedematous optic neuropathy. The mechanism of this effect on the optic nerves and on papilloedema is discussed; it seems not to be caused by a direct toxic action on the optic fibres but by the existence of chronic intracranial hypertension.

Topics: Humans; Intracranial Pressure; Male; Middle Aged; Optic Nerve Diseases; Papilledema; Perhexiline; Peripheral Nervous System Diseases; Piperidines