Cerebral ergotism under treatment with ergotamine and ritonavir
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Case report.
A 37-year-old woman with AIDS was admitted to our stroke unit with an 18-hour history of acute-onset speech disorder and weakness of the right-sided extremities. She was taking regular antiviral medication, including the protease inhibitor ritonavir. One week before admission, she suddenly developed severe headache, nausea, and vomiting, but no photo- or phonophobia. Headaches were diffusely located, with alternating intensity in the following days. After receiving paracetamol, which did not improve the headache, her treating physician prescribed ergotamine suppositories. She had actually administered five of these suppositories over 4 consecutive days (corresponding to a cumulative dose of 10 mg). Ergotamines never were described before. Her headache eventually resolved on day 4, when antiviral therapy was discontinued.
The patient had no vascular risk factors and no history of headache, but her sister had migraine headaches. Neurologic …
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