CYCLOSPORINE-A TOXICITY PRESENTING WITH ACUTE CEREBELLAR EDEMA AND BRAIN-STEM COMPRESSION

A 38-year-old man receiving cyclosporine A after bilateral lung transp lantation for cystic fibrosis presented with cortical blindness, gener alized seizures, and cerebellar edema. Progressive brainstem compressi on necessitated emergency posterior fossa decompression. Replacement o f cyclosporine A with an alternative immunosuppressive agent, FK506, w as followed by rapid neurological recovery and dramatic resolution of radiographic abnormalities. The etiology, clinical features, and radio graphic findings of cyclosporine A neurotoxicity are discussed. The pe rtinent literature is reviewed.