Acute paresthesia in a patient with migraine.
Ergot-containing medications are widely used to treat migraine patients in some countries but nowadays intoxication is only reported rarely. We report a 35-year-old woman who presented with acute paresthesia of the extremities. An angiogram revealed diffuse vasospasm of the femoral arteries bilaterally and the right brachial artery. History taking disclosed a possible interaction between ergotamine and macrolide antibiotics. The patient's symptoms improved rapidly after discontinuation of the offending medication and administration of vasodilators. This report aims to remind physicians that catastrophic adverse effects can develop through unrecognized drug interactions, even with widely prescribed medications given in safe dosages. The importance of a detailed drug history and knowledge of drug interactions cannot be overemphasized in the diagnosis of ergotism.
Tseng
Chih-Wei
CW
Department of Medicine, Hsinchu General Hospital, Hsinchu, Taiwan.
Wu
Chih-Cheng
CC
Tsai
Kuei-Chin
KC
Chen
Wen-Jone
WJ
D000208:Acute Disease; D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D000075202:Contraindications; D004878:Ergotamine / Q000009:adverse effects*; D005260:Female; D006801:Humans; D018942:Macrolides / Q000009:adverse effects*; D008881:Migraine Disorders / Q000188:drug therapy*; D010292:Paresthesia / Q000139:chemically induced* / Q000175:diagnosis; D058729:Peripheral Arterial Disease / Q000139:chemically induced* / Q000175:diagnosis; D014662:Vasoconstrictor Agents / Q000009:adverse effects
D000900:Anti-Bacterial Agents; D018942:Macrolides; D014662:Vasoconstrictor Agents; D004878:Ergotamine