Cycloserine Induced Neurotoxicity: A Rare Case Report

Cycloserine is one of the many drugs used in treatment of Multidrug Resistant Tuberculosis (MDR-TB). Neuropsychiatric complaints are common after cycloserine administration. Reports of neuroimaging in cycloserine neurotoxicity are rare. Authors hereby reports a case of 17-year-old female, who presented with hallucination and delirium since 2 weeks. She was a known case of pulmonary MDR-TB and was on Anti-Koch’s Treatment category IV (AKT) for the same since last 12 months. On clinical examination, the patient was conscious and co-operative but disoriented. Magnetic Resonance Imaging (MRI) revealed, symmetric hyperintensities on T2 weighted images in bilateral dentate nuclei with restriction of diffusion, on diffusion weighted images. In addition, two well- defined T2 hypointense ring enhancing lesions were seen in right parietal and occipital regions. Patient’s symptoms improved on stoppage of cycloserine. On follow-up MRI, 4 weeks after withdrawing the durg, there was complete reversal of MRI findings.