Journal of Anesthesia

, 25:405

Reversible cerebral vasoconstriction syndrome with limb myoclonus following intravenous administration of methylergometrine

  • Tomoko Ishibashi
  • Satoru Ishibashi
  • Tokujiro Uchida
  • Koichi Nakazawa
  • Koshi Makita
Clinical Report

DOI: 10.1007/s00540-011-1122-7

Cite this article as:
Ishibashi, T., Ishibashi, S., Uchida, T. et al. J Anesth (2011) 25: 405. doi:10.1007/s00540-011-1122-7
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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.

Keywords

Limb myoclonusMethylergometrineReversible cerebral vasoconstriction syndrome (RCVS)

Copyright information

© Japanese Society of Anesthesiologists 2011

Authors and Affiliations

  • Tomoko Ishibashi
    • 1
  • Satoru Ishibashi
    • 2
  • Tokujiro Uchida
    • 1
  • Koichi Nakazawa
    • 1
  • Koshi Makita
    • 1
  1. 1.Department of Anesthesiology, Graduate School of MedicineTokyo Medical and Dental UniversityBunkyo-ku, TokyoJapan
  2. 2.Department of Neurology and Neurological Science, Graduate School of MedicineTokyo Medical and Dental UniversityTokyoJapan