Convulsion melarsoprol

In 42 patients with late-stage Trypanosoma brucei gambiense trypanosomiasis, who relapsed after initial treatment with melarsoprol, a sequential combination of intravenous efiornithine (100 mg/kg every 6 hours for 4 days) followed by three daily injections of melarsoprol (3.6 mg/kg, up to 180 mg) was used (8). They were followed for 24 months. In one case, the administration of efiornithine had to be interrupted for 48 hours because of convulsions, but treatment was then resumed without recurrence. Other adverse effects during treatment were abdominal pain or vomiting (n = A each), diarrhea (n = 1), and loss of hearing (n = 1). Two patients died during treatment ... 

Encephalopathic syndromes complicating treatment of stage II human African trypanosomiasis with melarsoprol in 588 patients have been reviewed (8). The overall rate of encephalopathy was 5.8% and presented in three ways coma, convulsions, and psychotic reactions. The overall death rate was 38%. Comatose patients had a death rate of 52% and were commonly co-infected with malaria (14/16). Symptoms during treatment of fever (RR = 11.5), headache (RR = 2.5), bullous eruptions (RR = 4.5), and systolic hypotension (RR = 2.6) were associated with an increased risk of encephalopathic syndromes, especially coma. 

Vertigo lightheadedness nausea other gastrointestinal disturbances nightmares visual distirrbances headache confusion psychosis hypotension convulsions coma M iunine Antimoniate—similar to stibogluconate sodium Melarsoprol... 

Melarsoprol is the drug of choice for the treatment of late-stage meningoencephalitic trypanosomiasis caused by the west and east African strains of the disease. Because the drug has the potential for serious nervous system toxicities (e.g., convulsions, acute cerebral edema, and coma), the drug usually is administered in a hospital setting with supervision. An additional problem with melarsoprol is the development of resistance by the parasite. 

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