Abstract
An 82-year-old woman, undergoing hemodialysis (HD) for 7 years at an other hemodialysis clinic, developed right-orbital-varicella rash. She was given a reduced dose of valacyclovir (1,000 mg) after every HD session, as recommended for hemodialysis patients. The following day, she was admitted to our hospital due to gait disturbance, dysarthria and drowsiness. A CT scan of brain showed multiple lacunar infarcts, and electroencephrogram showed diffuse slowing without focal abnormalities. She was diagnosed as having valacyclovir neurotoxicity after differentiation the condition from of CVD and viral encephalopathy. Neurological symptoms improved after hemodialysis and she was discharged without any neurological symptoms after 4 courses of HD. Valacyclovir neurotoxicity could occur even with the reduced dosage of valacyclovir recommended for dialysis patients. The appropriate dosage of valacyclovir for HD patients should be reconsidered.
