Neurotoxic Effects from Quinolones

  : : Do you have any information on  Neurotoxic effects of Quinolones.
  : : Especially realted to CNS disorders and resulting in some unusual Neuropathies with strange presentations?  I have a relative this happened to yet have been unable to find  information, if you can provide what you know or where I can access information thank you.
  : Dear Jeanne:
  : Sorry to hear about your relative.  Quinolones can cause a variety of CNS symptoms.  As you probably know, they are GABA inhibitors therefore they can cause CNS stimulation.  Therefore, if taken with other CNS stimulants such as theophylline or high doses of caffeine, they can really demonstrate a stimulant-like effect.  Even knowing this, CNS side effects are infrequent.  The most common effect is headache and restlessness in 1-2%.  The myriad of other CNS symptoms include dizziness, lightheadedness, insomia, nightmares. hallucinations, manic reactions, toxic psychosis, tremor, ataxia, seizures, increases in ICP, paresthesia, weakness, lethargy, vertigo, and malaise.  It has been reported that a very rare patient might experience status epilepticus.  It is recommended in the package insert not to take the quinolones in a patient with a neurological disorder.  These adverse reactions can be found in any PDR that can be found in the library.  They can also be found in the the package insert and likely your
  : local pharmacist could give you a copy.  I hope that this helped.
  : Sincerely,
  : CCF Neuro[P] MD, RPS
  Thanks for all your information.  I couldn't find anything that says they Cause Neuropathies in people but that was my cousins diagnosis. His doctor claims this is a Neurotoxic effect caused by the drug, and that often these Neurotoxic reactions can take 6 months to years to resolve?
Dear Jeanne:
There are different types of neuropathy, it can be motor, sensory, or a combination of both.  We consider neuropathy to be involving the peripheral or central nervous system.  Since quinolones cause paresthesias, this would be considered to be a sensory neuropathy.  I am unsure whether the reported side effect of muscle weakness is peripheral or central but my guess would be peripheral and in that case it would be considered to be a peripheral motor neuropathy.  I hope this helps, it may be that you were looking up information that just described the reaction and not the pathophysiology of how the quinolones may work on the nervous system.  I hope that this helps.
Sincerely,
CCF Neuro[P] MD, RPS