Neuroimaging in Cycloserine Induced Neurotoxicity: A Rare Case Report

Abstract

Tuberculosis (TB) is an infectious disease. There is an increasing burden of Drug Resistant TB (DR-TB) which is not only difficult to treat and associated with adverse events during its treatment. Cycloserine is a broad spectrum antibiotic used as a second-line agent for DR-TB therapy. Psychiatric adverse drug reactions are well known. Neurotoxicity with the use of supplemental pyridoxine is rarely reported. We report a case of young boy who developed tilting of body to one side during therapy for DR-TB which included cycloserine. Magnetic Resonance Imaging (MRI) of the brain showed reversible bilateral symmetrical (T2/FLAIR) hyperintensity in dentate nuclei. Clinical and MRI findings were consistent with cycloserine toxicity. Symptoms resolved on withdrawing the drug. MRI findings showed marked reversibility