Spasm of the superior mesenteric artery complicating methysergide maleate therapy.

Abstract

Methysergide maleate has been used since the early sixties as prophylactic therapy in the management of migraine and other vascular headaches. Many mild side-effects have been reported such as nausea, dizziness and rashes, and also some major complications including retroperitoneal fibrosis, cardio-pulmonary changes, limb ischaemia, abdominal angina and bowel infarction (Graham et al., 1966; Bana et al., 1974; Rackley et al., 1966). The major complications of treatment are the result of vascular spasm and fibrosis (Graham et al., 1966) but the mode of action of methysergide in producing these changes is not known. The spasm resolves within seven days of discontinuing the drug and even extensive fibrosis can subsequently show some regression (Ureles and Rob, 1963). Vascular spasm has been reported in all the major limb arteries, the carotid, coronary and gastro- intestinal arteries and the aorta (Graham, 1967). However, the diagnosis of spasm has in most cases been made on the clinical findings alone, and ...