Greene F L, Ariyan S, Stansel H C
Surgery. 1977 Feb;81(2):176-9.
At the present time ergotism is due primarily to excessive use or abuse of ergot preparations for migraine headaches. The diagnosis may be made with the evidence of vascular ischemia in the presence of a history of migraines and its treatment with this drug. The therapy for the vasospasm is directed chiefly at the discontinuation of the ergot preparation, with further treatment aimed at the relief of symptoms or prevention of complications. A case is presented of lower extremity ischemia with impending gangrene of both feet in a patient with a history of chronic schizophrenia. Arteriograms revealed symmetrical vasospasm in the lower extremities as well as spasm of the superior mesenteric artery and its intestinal branches. This is believed to be the first documented case of mesenteric vasospasm due to ergotism. Treatment was instituted with low molecular weight dextran, tolazoline, and reserpine with rapid and complete resolution. Caution is advised in the use of ergot preparations in neuropsychiatric disorders.
目前，麦角中毒主要是由于过度使用或滥用麦角制剂来治疗偏头痛。在有偏头痛病史且使用该药物治疗的情况下，可根据血管缺血的证据做出诊断。血管痉挛的治疗主要是停止使用麦角制剂，进一步治疗旨在缓解症状或预防并发症。本文报告了一例有慢性精神分裂症病史的患者，出现双下肢缺血且双足即将发生坏疽的病例。血管造影显示双下肢对称性血管痉挛以及肠系膜上动脉及其肠支痉挛。据信这是首例有文献记载的因麦角中毒导致的肠系膜血管痉挛病例。采用低分子右旋糖酐、妥拉唑啉和利血平进行治疗，症状迅速完全缓解。建议在神经精神疾病中使用麦角制剂时要谨慎。
