Here we describe a case of ergotism that presented with ischemia in all four extremities. A 48-year-old man was admitted for pain and weakness in both upper extremities. He had a long history of migraine and had taken 3 mg of ergotamine daily for more than 21 years. Angiography demonstrated vasospasm involving all four extremities, which resolved partially following intra-arterial prostaglandin infusion. Intravenous nitroprusside was administered, and the patient stopped smoking and stopped taking ergotamine in an attempt to counteract the vasospasm. Follow-up computed tomography angiogram revealed that both brachial arteries had normalized. Thus, in this case of ergotism, severe vasospasm in all of the extremities was resolved with appropriate management.
Angiography ; Brachial Artery ; Ergotamine ; Ergotism* ; Extremities* ; Follow-Up Studies ; Humans ; Ischemia* ; Middle Aged ; Migraine Disorders ; Nitroprusside ; Smoke ; Smoking ; Upper Extremity

Drugs containing ergotamine are widely used in the treatment of migraine. Spastic vasoconstriction is one of the most serious side effects even with recommended dosage. We report a case of 63-year-old male with severe arterial occlusion of the upper limbs which might be related with vasospasm caused by ergotamine-containing medication because of migraine for 15 years. He was treated with bypass graft, sympathicotomy and heparin and prostaglandin E1 infusion. But dramatic clinical reversal of the vasospasm was obtained after withdrawal of ergotamine.
Alprostadil ; Ergotamine ; Heparin ; Humans ; Male ; Middle Aged ; Migraine Disorders ; Muscle Spasticity ; Peripheral Vascular Diseases ; Transplants ; Upper Extremity ; Vasoconstriction

Ergotamine-induced limb ischemia is an extremely rare case. We present a case of a 64-year-old man, who developed ischemia on the right upper extremity due to long-term use of Ergot for migraine headache. Angiography revealed diffused, smooth, and tapered narrowing of the brachial artery. The patient was successfully treated with intravenous nitroprusside.
Arm/*blood supply ; *Brachial Artery/radiography ; Ergotamine/*adverse effects ; Humans ; Infusions, Intravenous ; Ischemia/*chemically induced/drug therapy/radiography ; Male ; Middle Aged ; Migraine/drug therapy ; Nitroprusside/administration & dosage

Adult ; Echocardiography ; Ergotamine ; adverse effects ; Female ; Fibrosis ; chemically induced ; diagnostic imaging ; drug therapy ; pathology ; Humans ; Migraine Disorders ; drug therapy ; Serotonin Receptor Agonists ; adverse effects