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Acta Neurologica Belgica
Published in: Acta Neurologica Belgica 1/2018

01-03-2018 | Letter to the Editor

An easily overlooked cause of toxic encephalopathy: methylene blue in a patient on an SSRI

Authors: Pieter-Jan Honoré, Nancy Deianova, Griet Loret, Dimitri Hemelsoet

Published in: Acta Neurologica Belgica | Issue 1/2018

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Excerpt

Methylene blue (MB) is a multiple-use dye considered to be safe for intravenous (IV) application [1]. However, patients simultaneously taking selective serotonin reuptake inhibitors (SSRIs) can exhibit a variety of neurological symptoms following IV MB [2]. Given the monoamine oxidase A (MAO-A) inhibitory action of MB, these symptoms are hypothesized to develop due to serotonin toxicity (ST) [2]. We present the case of a patient who suffered an episode of encephalopathy after parathyroidectomy. To our knowledge this is the first report on MB-associated encephalopathy in a patient taking sertraline. …
Literature
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Ng BK, Cameron AJ (2010) The role of methylene blue in serotonin syndrome: a systematic review. Psychosomatics 51(3):194–200CrossRefPubMed
2.
Pollack G, Pollack A, Delfiner J, Fernandez J (2009) Parathyroid surgery and methylene blue: a review with guidelines for safe intraoperative use. Laryngoscope 119(10):1941–1946CrossRefPubMed
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Dunkley EJC, Isbister GK, Sibbritt D, Dawson AH, Whyte IM (2003) The hunter serotonin toxicity criteria: simple and accurate diagnostic decision rules for serotonin toxicity. Qjm-Int J Med 96(9):635–642CrossRef
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Trombetti A, Christ ER, Henzen C, Gold G, Brandle M, Herrmann FR et al (2016) Clinical presentation and management of patients with primary hyperparathyroidism of the Swiss Primary Hyperparathyroidism Cohort: a focus on neuro-behavioral and cognitive symptoms. J Endocrinol Invest 39(5):567–576CrossRefPubMed
Metadata
Title
An easily overlooked cause of toxic encephalopathy: methylene blue in a patient on an SSRI
Authors
Pieter-Jan Honoré
Nancy Deianova
Griet Loret
Dimitri Hemelsoet
Publication date
01-03-2018
Publisher
Springer International Publishing
Published in
Acta Neurologica Belgica / Issue 1/2018
Print ISSN: 0300-9009
Electronic ISSN: 2240-2993
DOI
https://doi.org/10.1007/s13760-017-0823-6

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