Abstract
Background Serotonin syndrome is an iatrogenic disorder that results from serotonergic overactivity. Severe myoc- lonus and increased restlessness are hallmarks of the disorder. Methods We report a case of serotonin syndrome related to poor drug elimination. Results 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. Conclusion 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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 258-260 |
| Number of pages | 3 |
| Journal | Neurocritical Care |
| Volume | 12 |
| Issue number | 2 |
| DOIs | |
| State | Published - Apr 1 2010 |
| Externally published | Yes |
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Keywords
- Autonomic instability
- Myoclonus Hyperreflexia
- Neurologic manifestations
- Serotonin syndrome
ASJC Scopus subject areas
- Critical Care and Intensive Care Medicine
- Clinical Neurology
Cite this
A perfect storm in the emergency department. / Yee, Alan Howe; Wijdicks, E. F M.
In: Neurocritical Care, Vol. 12, No. 2, 01.04.2010, p. 258-260.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - A perfect storm in the emergency department
AU - Yee, Alan Howe
AU - Wijdicks, E. F M
PY - 2010/4/1
Y1 - 2010/4/1
N2 - Background Serotonin syndrome is an iatrogenic disorder that results from serotonergic overactivity. Severe myoc- lonus and increased restlessness are hallmarks of the disorder. Methods We report a case of serotonin syndrome related to poor drug elimination. Results 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. Conclusion 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.
AB - Background Serotonin syndrome is an iatrogenic disorder that results from serotonergic overactivity. Severe myoc- lonus and increased restlessness are hallmarks of the disorder. Methods We report a case of serotonin syndrome related to poor drug elimination. Results 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. Conclusion 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.
KW - Autonomic instability
KW - Myoclonus Hyperreflexia
KW - Neurologic manifestations
KW - Serotonin syndrome
UR - http://www.scopus.com/inward/record.url?scp=77953617441&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77953617441&partnerID=8YFLogxK
U2 - 10.1007/s12028-009-9309-6
DO - 10.1007/s12028-009-9309-6
M3 - Article
C2 - 20012708
AN - SCOPUS:77953617441
VL - 12
SP - 258
EP - 260
JO - Neurocritical Care
JF - Neurocritical Care
SN - 1541-6933
IS - 2
ER -