Neurological emergencies from prescription drugs

As our knowledge and understanding of medicine has expanded, the pharmacologic options to manage and treat disease have as well. Many patients are prescribed one or more medications for management of acute and chronic medical conditions, each associated with its own potential adverse effects. The brain and neurologic system as a whole can sometimes be affected by direct toxicity, withdrawal, or the adverse effects of these medications. Prompt recognition and appropriate intervention is necessary in order to reverse or prevent ongoing clinical decline. Particularly challenging is the situation where a medication is having the desired effect systemically, but is causing simultaneous neurotoxicity, where cessation of the medication can worsen serious illness, but continuation may result in permanent or potentially catastrophic neurologic injury. In this chapter we will review common neurologic complications secondary to toxicities, withdrawal, or adverse effects of prescription medications.