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Sildenafil-induced spinal cord infarction: a case report

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Abstract

Spinal cord infarction is a rare condition, accounting for only a small percentage of strokes. It can be classified into cervical and thoracolumbar infarctions, with various factors contributing to its occurrence. Sildenafil, a phosphodiesterase type 5 inhibitor commonly used for erectile dysfunction, has been associated with cardiovascular side effects, including transient hypotension. In this case report, we present the unusual occurrence of spinal cord infarction in a 65-year-old man who had self-administered high doses of sildenafil without a doctor's prescription. The patient experienced severe radicular pain in the lumbar region and subsequent weakness in the lower limbs. Evaluation revealed an anterior spinal cord infarction in the thoracic region, confirmed by MRI imaging. After excluding other potential causes, it was concluded that the intake of sildenafil likely led to systemic hypotension, resulting in spinal cord infarction. This case highlights the importance of considering sildenafil as a possible contributor to spinal cord infarction, particularly when used at high doses. Further studies are needed to better understand the relationship between sildenafil and vascular complications, including spinal cord infarction.

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Funding

This research was funded by Shiraz University of Medical Sciences [grant number is NOT APPLICABLE]. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Authors and Affiliations

  1. Department of Neurology, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran

    Mohsen Gholami

  2. Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran

    Maryam Fard

  3. Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

    Maryam Poursadeghfard

Authors
  1. Mohsen Gholami
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  2. Maryam Fard
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Contributions

Mohsen Gholami and Maryam Poursadeghfard conceived and designed the study, M. Gholami followed the patient and was the first person who examined him and prescribed. Maryam Fard wrote and revised the manuscript. Maryam Poursadgfard provided ethical guidance and supervised the study and contributed to the data interpretation. All authors read and approved the final manuscript. Authorship: All authors have made substantial contributions to the conception, design, acquisition, analysis, or interpretation of data for the work. All authors have drafted or revised the work critically for important intellectual content. All authors have approved the final version of the manuscript and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Maryam Poursadeghfard.

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Conflict of interest

The authors declare that the competing interests do not compromise the scientific rigor or ethical standards of the research or its findings. The authors have read and adhered to the journal's policy on competing interests.

Ethical approval

This work has been conducted in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1975, as revised in 2013. Informed consent was obtained from the patient for the publication of this case report and any accompanying images. (IR.SUMS.MED.REC.1402.469).

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Gholami, M., Fard, M. & Poursadeghfard, M. Sildenafil-induced spinal cord infarction: a case report. Acta Neurol Belg (2024). https://doi.org/10.1007/s13760-024-02573-2

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