Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Neurocrit Care. 2010 Apr;12(2):258-60. doi: 10.1007/s12028-009-9309-6.
Serotonin syndrome is an iatrogenic disorder that results from serotonergic overactivity. Severe myoclonus and increased restlessness are hallmarks of the disorder.
We report a case of serotonin syndrome related to poor drug elimination.
A 74-year-old white female with moderate to severe Alzheimer's dementia was brought to the emergency department for increasingly aggressive behavior. Upon admission, her risperidone dose was increased and citalopram continued. Several days later, she developed diffuse limb and facial myoclonus, spontaneous clonus, diaphoresis, and fever. Her symptoms completely resolved after discontinuation of these medications.
Serotonin syndrome should be considered in the differential when elderly patients present with severe myoclonus. If unrecognized, this syndrome can lead to more severe manifestations including rhabdomyolysis, renal failure, and coma.
血清素综合征是一种由血清素能活性过度引起的医源性疾病。严重肌阵挛和不安增加是该疾病的标志。
我们报告了一例与药物清除不良相关的血清素综合征病例。
一名 74 岁的白人女性，患有中度至重度阿尔茨海默病，因行为日益激进而被送往急诊室。入院时，她的利培酮剂量增加，同时继续服用西酞普兰。几天后，她出现了广泛的肢体和面部肌阵挛、自发性阵挛、出汗和发热。停用这些药物后，她的症状完全缓解。
当老年患者出现严重肌阵挛时，应考虑血清素综合征的鉴别诊断。如果未被识别，这种综合征可导致更严重的表现，包括横纹肌溶解、肾衰竭和昏迷。
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