title: Reversible cerebral vasoconstriction syndrome with limb myoclonus following intravenous administration of methylergometrine.
abstract: Neurological deficits associated with methylergometrine have been reported primarily as a result of reversible cerebral vasoconstriction syndromes (RCVS). RCVS are characterized by reversible multifocal vasoconstrictions of the cerebral arteries heralded by acute severe headache with or without neurological deficits. Here, we present the first case of suspected RCVS with transient limb myoclonus following the intravenous administration of methylergometrine during cesarean section. A 31-year-old woman who received slowly infused intravenous methylergometrine during a cesarean section suddenly reported severe occipital headache after 40 min, followed by apnea and unconsciousness for 8 min. A second administration of methylergometrine to treat the weakness of her uterine contractions resulted in a repeated loss of consciousness within minutes and the development of limb myoclonus. No abnormalities were detected by brain computerized tomography, magnetic resonance imaging, and electroencephalogram. She fully recovered spontaneously within 12 h. We consider that the transient limb myoclonus in our patient appeared as a result of RCVS caused by the intravenous administration of methylergometrine.
authors: Department of Anesthesiology, Graduate School of Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan. timane@tmd.ac.jp
authors: Tomoko
authors: T
authors: Ishibashi
authors: Satoru
authors: S
authors: Ishibashi
authors: Tokujiro
authors: T
authors: Uchida
authors: Koichi
authors: K
authors: Nakazawa
authors: Koshi
authors: K
authors: Makita
mesh_terms: D000328:Adult; D000767:Anesthesia, Epidural; D000773:Anesthesia, Obstetrical; D001921:Brain / Q000000981:diagnostic imaging; D002561:Cerebrovascular Disorders / Q000139:chemically induced* / Q000503:physiopathology; D002585:Cesarean Section; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008279:Magnetic Resonance Imaging; D008755:Methylergonovine / Q000008:administration & dosage / Q000009:adverse effects*; D009207:Myoclonus / Q000139:chemically induced*; D010120:Oxytocics / Q000008:administration & dosage / Q000009:adverse effects*; D011247:Pregnancy; D014057:Tomography, X-Ray Computed; D014590:Uterine Contraction / Q000187:drug effects; D014661:Vasoconstriction / Q000187:drug effects*
chemical_list: D010120:Oxytocics; D008755:Methylergonovine