Early-onset severe isoniazid-induced motor-dominant neuropathy: a case report.

Nervous system toxicity with current antituberculosis pharmacotherapy is relatively uncommon, although the frequency of the usage of antituberculosis therapy requires that physicians should be aware of such toxicity. Peripheral neuropathy is a rare adverse effect associated with isoniazid, and it occurs after the prolonged use of this drug [1]. This usually presents with paresthesias which can be accompanied by muscle aches, occasionally muscular weakness, and can progress to more severe symptoms such as ataxia [1]. Risk factors for developing neuropathy after isoniazid therapy include old age, slow acetylator status, diabetes, renal failure, alcoholism, malnutrition, HIV infection, chronic hepatic failure and pregnancy [1]. Here we report a case of acute isoniazid-induced peripheral neuropathy with predominant motor functional impairment associated with tetraplegia. To our knowledge, there has been no report of a patient who developed severe peripheral neuropathy barely 2 weeks after the initial administration of conventional doses of isoniazid. This atypical clinical course should be known in order to improve the outcome of adverse events due to antituberculosis treatment.