[Dorsal medulla oblongata stroke after a wasp sting].
BACKGROUND
Although wasp stings can cause local reactions such as pain, flare, edema, swelling and severe reactions, including anaphylaxis; neurological vascular complications are rare.


METHODS
We report a case of a 36-year-old male who developed focal neurological symptoms after a wasp sting. The brain MRI showed an infarct in the left dorsal medulla. The blood test has showed an elevated level of venom-specific IgE antibodies and the skin test with wasp venom was highly positive. Improvement occurred rapidly after treatment with methylprednisone. The postulated mechanisms include vasoconstriction and platelet aggregation secondary to an injection of distinct allergens contained in wasp venom.


CONCLUSIONS
It would thus be important to ask patients about any recent wasp sting, in order to provide appropriate treatment.
Service de Neurologie, Hôpital Broussais, Saint-Malo.
G
G
Taurin
M L
ML
Canneva-Bourel
J-M
JM
Delafosse
J
J
Poirier
M
M
Merienne
D000328:Adult; D000818:Animals; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000918:Antibody Specificity; D002544:Cerebral Infarction / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D007073:Immunoglobulin E / Q000276:immunology; D007299:Insect Bites and Stings / Q000150:complications*; D008279:Magnetic Resonance Imaging; D008297:Male; D008526:Medulla Oblongata / Q000098:blood supply / Q000473:pathology*; D008775:Methylprednisolone / Q000627:therapeutic use; D010974:Platelet Aggregation; D012848:Sinoatrial Block / Q000209:etiology; D012882:Skin Tests; D014661:Vasoconstriction; D014839:Vomiting / Q000209:etiology; D014862:Wasp Venoms / Q000009:adverse effects* / Q000276:immunology; D014863:Wasps
D000893:Anti-Inflammatory Agents; D014862:Wasp Venoms; D007073:Immunoglobulin E; D008775:Methylprednisolone