[Progressive cerebellar atrophy following acute antidepressant intoxication].
A 37-year-old woman presented with acute cerebellar atrophy after ingesting toxic doses of tricyclic antidepressants in an attempt of suicide. Two hours after ingestion, she was comatose and showed myoclonus of the limbs, and eventually developed status epileptics. The patient underwent general anesthesia with thiopental, she had hyperpyrexia with elevated muscle enzymes and leukocytosis. These clinical and laboratory features suggested that she had serotonin syndrome (SS). After recovery from coma and hyperpyrexia that had lasted for 7 days, she showed cerebellar ataxia, and progressive cerebellar atrophy of CT scan. As well as neuroleptic malignant syndrome, the SS may cause cerebellar degeneration, probably due to sustained hyperpyrexia.
Fujino
Y
Y
Fifth Department of Internal Medicine, School of Medicine, Fukuoka University.
Tsuboi
Y
Y
Shimoji
E
E
Takahashi
M
M
Yamada
T
T
D000328:Adult; D000929:Antidepressive Agents, Tricyclic / Q000506:poisoning*; D001284:Atrophy / Q000139:chemically induced; D002524:Cerebellar Ataxia / Q000139:chemically induced; D002531:Cerebellum / Q000473:pathology*; D005260:Female; D006801:Humans; D008305:Malignant Hyperthermia / Q000209:etiology; D009459:Neuroleptic Malignant Syndrome / Q000209:etiology; D009661:Nortriptyline / Q000506:poisoning*; D020230:Serotonin Syndrome / Q000139:chemically induced; D013406:Suicide, Attempted
D000929:Antidepressive Agents, Tricyclic; D009661:Nortriptyline