Acute headache as a presenting symptom of tacrolimus encephalopathy

• Published in: Journal of neurology, neurosurgery and psychiatry Vol. 74; no. 8; pp. 1126 - 1127
• Main Authors: Kiemeneij, I M, de Leeuw, F-E, Ramos, L M P, van Gijn, J
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.08.2003; BMJ; BMJ Publishing Group LTD; BMJ Group
• Subjects: Acute Disease; Adult; Biological and medical sciences; Blood pressure; Brain - pathology; Brain Diseases - chemically induced; Brain Diseases - diagnosis; Cyclosporine - adverse effects; Cyclosporine - therapeutic use; Cystic Fibrosis - surgery; Diagnosis, Differential; Drug Therapy, Combination; Drug toxicity and drugs side effects treatment; Female; headache; Headache - chemically induced; Headaches; Humans; Image Enhancement; Immunosuppressive Agents - adverse effects; Immunosuppressive Agents - therapeutic use; Ischemia; leucencephalopathy; Lung Transplantation; Magnetic Resonance Imaging; Medical sciences; Neurologic Examination - drug effects; Neurotoxicity; Pharmacology. Drug treatments; Postoperative Complications - chemically induced; Prednisone - administration & dosage; Recurrence; Short Report; Tacrolimus - adverse effects; Tacrolimus - therapeutic use; tacrolimus encephalopathy; Toxicity: nervous system and muscle; Transplants & implants; Human; Headache; Nervous system diseases; Respiratory disease; Toxicity; Acute; Lung; Metabolic diseases; Lactone; Cystic fibrosis; Transplantation; Cerebral disorder; Genetic disease; Macrocycle; Case study; Pain; Tacrolimus; Surgery; Encephalopathy; Central nervous system disease; Digestive diseases; Immunosuppressive agent; Neurological disorder; Pancreatic disease
• ISSN: 0022-3050; 1468-330X
• DOI: 10.1136/jnnp.74.8.1126

A 24 year old woman presented with a sudden excruciating headache mimicking an acute vascular event. She had undergone a lung transplantation because of cystic fibrosis and was receiving maintenance treatment with tacrolimus and prednisone. Ancillary investigation excluded vascular causes. Magnetic resonance imaging demonstrated hyperintense lesions in the infratentorial and parieto-occipital regions consistent with posterior leucencephalopathy syndrome. Both her clinical condition improved and the lesions disappeared completely after withdrawal of tacrolimus, suggesting that her condition could be explained by a tacrolimus encephalopathy.