Transplant medications (cyclosporin or tacrolimus/FK506) are the major reason for neurological problems in recipients. Neurological side effects may be worsened by or accompany low magnesium levels, hypertension, low cholesterol, high-dose steroids or beta-lactam antibiotic therapy.
Minor neurological complications occur in about 20% of patients receiving tacrolimus and most commonly include hand tremors, sleep disturbances, headaches and mood changes. These side effects tend to be most pronounced soon after transplant.
Fortunately, more serious neurological complications are uncommon and occur in less than 5% of patients. These may include:
- Encephalopathy as a manifestation of a cerebrocerebellar syndrome resulting in seizures and cortical blindness
- Akinetic mutism, characterized by an apparent state of wakefulness, with no voluntary muscle activity
- A syndrome of unknown cause characterized by high ammonia levels in the blood that can result in severe neurological events or death