Unilateral Seizures following Vincristine Intravenous Injection

A case of acute central nervous system toxicity following the intravenous injection of vincristine was observed in a patient treated with a chemotherapy regimen including cyclophosphamide, doxorubicin and prednisone for non-Hodgkin lymphoma. The neurological symptoms consisted of right-sided epileptiform jacksonian seizures limited to the face, that lasted about 10 min, followed by spontaneous recovery. A cerebrospinal fluid study and computed tomographic scan of the brain failed to reveal any central nervous system lymphomatous involvement.

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Liposome-mediated augmentation of brain SOD and catalase inhibits CNS O2 toxicity

Journal of Applied Physiology ◽

10.1152/jappl.1984.57.6.1674 ◽

1984 ◽

Vol 57 (6) ◽

pp. 1674-1681 ◽

Cited By ~ 54

Author(s):

T. Yusa ◽

J. D. Crapo ◽

B. A. Freeman

Keyword(s):

Central Nervous System ◽

Superoxide Dismutase ◽

Nervous System ◽

Enzyme Activity ◽

Intravenous Injection ◽

Biological Effect ◽

Central Nervous System Toxicity ◽

Hyperbaric O2 ◽

Dose Dependent ◽

System Toxicity

Enzymes specific for O-2 and H2O2 metabolism [superoxide dismutase (SOD) and catalase] can be delivered to the rat brain following entrapment in liposomes and intravenous injection and will protect against hyperbaric O2-induced convulsions in rats. Liposome-mediated superoxide dismutase and catalase augmentation of brain enzyme activity was 2.7-fold and 1.9-fold, respectively, 15 min after intravenous injection of superoxide dismutase plus catalase-entrapped liposomes. Rats treated with liposomes containing superoxide dismutase plus catalase 2 h before 6 ATA 100% O2 exposure had the time to convulsion extended three times that of controls. This protective effect was dose-dependent and was primarily due to augmentation of catalase activity. These findings show O-2 and H2O2 are important mediators of hyperbaric O2-induced central nervous system toxicity and that liposome-mediated augmentation of brain antioxidant enzymes has a biological effect.

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Comparison on Reactivity of Fe(III) and AI(III) Compounds in the Presence of Hydrogen Peroxide: Its Relevance to Possible Origin for Central Nervous System Toxicity by Aluminum Ion

Zeitschrift für Naturforschung C ◽

10.1515/znc-1995-7-816 ◽

1995 ◽

Vol 50 (7-8) ◽

pp. 571-577 ◽

Cited By ~ 3

Author(s):

Yuzo Nishida ◽

Sayo Ito

Keyword(s):

Hydrogen Peroxide ◽

Central Nervous System ◽

Nervous System ◽

High Activity ◽

Furan Ring ◽

Nitrilotriacetic Acid ◽

Central Nervous System Toxicity ◽

The Brain ◽

System Toxicity

Abstract The iron(III) compounds with several aminocarboxylate chelates containing an aryl or furan substituent exhibit high activity in enhancement of the reactivity of hydrogen peroxide, leading to facile hydroxylation at benzene ring, and to degradation of furan ring, but no such activity was observed for the corresponding Al(III) compounds. These results were interpreted in terms of the molecular orbital consideration, and lack of the activity of the Al(III) complexes was attributed to lack of electrophilic nature of the peroxide adduct due to the absence of a d-orbital: this may explain the fact that there were no tumors in Al-NTA (nitrilotriacetic acid)-treated rats. Based on the facts observed in this study, the decreased function of iron(III) ions for synthesizing neurotransmitters in the brain was assumed to be one of the possible origin for the neurotoxicity by injection of the Al(III) salts in vivo.

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Monitoring of tricyclic antidepressant plasma levels and clinical response: a review of the literature. Part II

Psychiatry and Psychobiology ◽

10.1017/s0767399x00002911 ◽

1989 ◽

Vol 4 (2) ◽

pp. 81-90 ◽

Cited By ~ 2

Author(s):

I.R. De Oliveira ◽

P.A.S. Do Prado-Lima ◽

B. Samuel-Lajeunesse

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Elderly Patients ◽

Plasma Levels ◽

Tricyclic Antidepressant ◽

Review Of The Literature ◽

Central Nervous System Toxicity ◽

Routine Measurement ◽

System Toxicity

SummaryPart II of this paper contains some general considerations on tricyclic antidepressant (TCA) monitoring. Long-term assessment of TCA plasma levels is advised by the few existent studies, although each of these focusses on different aspects. Cardiovascular and central nervous system toxicity is reviewed as well as pharmacokinetics and the importance of protein binding. Some consideration is also given to their use in elderly patients. The authors conclude that although available data support its usefulness in many situations, routine measurement of TCA levels is not warranted.

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Local Anesthetic-Induced Central Nervous System Toxicity during Interscalene Brachial Plexus Block: A Case Series Study of Three Patients

Journal of Clinical Medicine ◽

10.3390/jcm10051013 ◽

2021 ◽

Vol 10 (5) ◽

pp. 1013

Author(s):

Daniel Spitzer ◽

Katharina J. Wenger ◽

Vanessa Neef ◽

Iris Divé ◽

Martin A. Schaller-Paule ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Brachial Plexus ◽

Local Anesthetic ◽

Local Anesthetics ◽

Brachial Plexus Block ◽

Central Nervous System Toxicity ◽

Interscalene Brachial Plexus Block ◽

Plexus Block ◽

System Toxicity

Local anesthetics are commonly administered by nuchal infiltration to provide a temporary interscalene brachial plexus block (ISB) in a surgical setting. Although less commonly reported, local anesthetics can induce central nervous system toxicity. In this case study, we present three patients with acute central nervous system toxicity induced by local anesthetics applied during ISB with emphasis on neurological symptoms, key neuroradiological findings and functional outcome. Medical history, clinical and imaging findings, and outcome of three patients with local anesthetic-induced toxic left hemisphere syndrome during left ISB were analyzed. All patients were admitted to our neurological intensive care unit between November 2016 and September 2019. All three patients presented in poor clinical condition with impaired consciousness and left hemisphere syndrome. Electroencephalography revealed slow wave activity in the affected hemisphere of all patients. Seizure activity with progression to status epilepticus was observed in one patient. In two out of three patients, cortical FLAIR hyperintensities and restricted diffusion in the territory of the left internal carotid artery were observed in magnetic resonance imaging. Assessment of neurological severity scores revealed spontaneous partial reversibility of neurological symptoms. Local anesthetic-induced CNS toxicity during ISB can lead to severe neurological impairment and anatomically variable cerebral lesions.

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