Ergotamine-induced acute vascular insufficiency of the lower limb - A casereport

Ergotamine-containing drugs are widely used in the treatment of acute migra ine attacks. Spastic vasoconstriction is one of the possible side effects u sually affecting the lower extremities and sometimes leading to gangrene. A 28-year-old woman was hospitalized for severe acute arterial insufficiency of the limbs. The initial surgical approach was not successful since the d iagnosis was missed. Overuse of ergotamine derivative was acknowledged by t he patient, who had a long history of migraine headaches. Therefore, the pa tient was treated conservatively with intravenous heparin and prostaglandin infusion and sympatheticolysis via epidural catheter. The vascular complic ations, angiographic findings, and different modalities of treatment of erg otamine-induced peripheral vascular insufficiency of the lower limb are rev iewed.