Valacyclovir Neurotoxicity: Two Case Reports and a Review of the Literature
Bibliographic record
Abstract
ABSTRACT Valacyclovir is a prodrug of acyclovir. Headache is the most common central nervous system side effect of acyclovir. Elderly patients and people with chronic renal failure are most susceptible to the neurotoxic effects of acyclovir, which usually manifest as confusion, hallucinations, dizziness, irritability, ataxia, tremor, myoclonus, and seizures. The symptoms usually occur within 3 days of initiation of therapy and resolve within 5 days after discontinuation. The results of lumbar puncture and computed tomography of the head are essentially unremarkable. Levels of acyclovir in the plasma do not correlate with the toxic effects experienced. The most common electroencephalographic abnormality is diffuse generalized slowing of brain wave activity. Two cases of valacyclovir neurotoxicity are presented, along with a review of the literature on acyclovir neurotoxicity. RESUME Le valacyclovir est un biomedicament de l’acyclovir. Les cephalees representent l’effet indesirable sur le systeme nerveux central le plus courant de l’acyclovir. Les patients âges et les personnes atteintes d’insuffisance renale chronique sont les plus sensibles aux effets neurotoxiques de cet agent, qui se manifestent sous les formes suivantes : confusion, hallucinations, etourdissements, irritabilite, ataxie, tremblements, myoclonies et convulsions. Les symptomes surviennent habituellement dans les trois jours suivant le debut du traitement et se resorbent dans les cinq jours suivant son interruption. Le liquide cephalo-rachidien et les cliches de la tomographie cerebrale ne revelent essentiellement rien de particulier. Les taux plasmatiques de l’acyclovir ne presentent pas de correlation avec les effets toxiques eprouves. L’alteration electroencephalographique la plus courante est un reduction diffuse de l'activite cerebrale. Deux cas de neurotoxicite au valacyclovir sont presentes avec une analyse de la litterature sur ce type de neurotoxicite.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.004 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.011 | 0.008 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.003 | 0.005 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.007 | 0.003 |
| Insufficient payload (model declined to judge) | 0.005 | 0.004 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".