Segmental myoclonus following hepatorenal transplant and tacrolimus immunosuppression

A 16-year-old girl with methylmalonic acidemia complicated by chronic kidney disease underwent hepatorenal transplantation with excellent post-operative course. She was discharged on prednisone, mycophenolate mofetil, tacrolimus, trimethoprim-sulfamethoxazole, and valganciclovir. Her peak trough of tacrolimus during initiation was 17.1 ng/mL (goal: 10-15 ng/mL). 1.5 weeks after transplant she developed intermittent “jerking” about her abdominal incision. Soon after, she slumped, developed rightward head version with right face/eyelid twitching, and became unresponsive with generalized tremulousness for 2 minutes.
Source: Pediatric Neurology - Category: Neurology Authors: Tags: Short Communication Source Type: research