Dihydroergotamine mesilate overdose
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Dihydroergotamine mesilate overdose
Lft hemiplegia and left fourth, fifth, sixth and seventh cranial nerve palsies secondary to crebral infarction following dihydroergotamine mesilate overdose: case report A 7-year-old boy developed left hemiplegia and left fourth, fifth, sixth and seventh cranial nerve palsies secondary to cerebral infarction following dihydroergotamine mesilate overdose [time to reactions onsets not stated]. He had been receiving dihydroergotamine mesilate for acute-on-chronic headaches. The boy presented with acute left-sided weakness and double vision. He had a prior history of mild illness, lethargy and acute-onchronic headaches. He had been prescribed dihydroergotamine mesilate [dihydroergotamine] 2 mg/mL for acute-on-chronic headaches. However, he had received 15mL (30mg) of dihydroergotamine mesilate orally in total over 3 days at home, with no treatment precautions in place, conferring a significant dihydroergotamine mesilate overdose, as the suggested dihydroergotamine mesilate dosing regimens for migraine treatment in children younger than 9 years is 0.5mg every eight hours to a maximum of 20 doses (10mg total). He was not taking other migraine treatments along with dihydroergotamine mesilate. On examination, he exhibited left hemiplegia and reduced power (Medical Research Council scale: 3 to 4/5) in the right arm and leg. Additionally, left fourth, fifth, sixth and seventh cranial nerve palsies were present. Reflexes were absent in the left leg and were brisk in the left arm. Peripheral pulses were palpable, and he was normotensive. A full stroke evaluation was completed and excluded other causes of infarction, such as thrombophilia risk factors. A brain MRI revealed bihemispheric white matter lesions localised to cerebral watershed zones and the cerebellar hemisphere distributed in a parasagittal location [outcomes not stated]. Bednarczuk NF, et al. Ischemic Stroke Following Ergotamine Overdose. Pediatric Neurology 101: 81-82, Dec 2019. Available from: URL: http://doi.org/10.1016/ j.pediatrneurol.2019.07.016
0114-9954/20/1822-0001/$14.95 Adis © 2020 Springer Nature Switzerland AG. All rights reserved
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Reactions 19 Sep 2020 No. 1822
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