Toxic metabolic encephalopathy after parathyroidectomy with methylene blue localization.
OBJECTIVE
To determine the correlation between methylene blue use and toxic metabolic encephalopathy in patients undergoing surgery for primary hyperparathyroidism.


METHODS
A retrospective study of 193 patients was performed to collect demographic, perioperative, and postoperative data. Patients were divided into two groups: Group A (postoperative neurological sequelae) and Group B (no neurological sequelae). All data points were compared between the groups.


RESULTS
Twelve of 193 patients were placed in Group A; 181 patients were placed in Group B. Ten patients in Group A were female, and 10 patients were older than 60 years. Of the patients in Group A, 100% were taking a serotonin reuptake inhibitor (SRI). In Group B, 8.8% of patients were taking an SRI.


CONCLUSIONS
All the patients who experienced transient neurological events were taking an SRI. A correlation can be made between methylene blue infusion and SRI usage.


CONCLUSIONS
Patients taking SRIs may represent a high-risk group for postoperative neurological events when methylene blue is utilized.
Kartha
Swapna S
SS
University of Louisville School of Medicine, Department of Surgery, Division of Otolaryngology, Louisville, Kentucky, USA.
Chacko
Chris E
CE
Bumpous
Jeffrey M
JM
Fleming
Muffin
M
Lentsch
Eric J
EJ
Flynn
Michael B
MB
D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000601:surgery; D008297:Male; D008751:Methylene Blue / Q000009:adverse effects*; D008875:Middle Aged; D020258:Neurotoxicity Syndromes / Q000209:etiology*; D016105:Parathyroidectomy; D012189:Retrospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects
D008751:Methylene Blue; D017367:Selective Serotonin Reuptake Inhibitors