Abstract | INTRODUCTION:
Methylene blue (MB) infusion is frequently used to localize the parathyroid glands during parathyroidectomy and generally considered safe. Several recent reports suggest neurological toxicity and post-operative altered mental state typically after large dose infusions. The mechanism by which MB has neurotoxic effects in some patients remains uncertain. METHODS/RESULTS: CASE REPORT: A 67-year-old male underwent lumbar laminectomy followed by parathyroidectomy. Postoperatively, he was comatose (Glasgow Coma Scale of 7) and underwent extensive neurological evaluation. Brain computed tomography (CT) imaging and CT angiography revealed no ischemia, vessel occlusion, or hemorrhage. Electroencephalogram (EEG) showed only slowing of cerebral hemispheric activity bilaterally. Over the next 48 h, his mental status slowly improved and the patient made a full neurological recovery (Glasgow Coma Scale 15). CONCLUSION:
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Authors | Michael Rowley, Kevin Riutort, David Shapiro, John Casler, Emir Festic, William D Freeman |
Journal | Neurocritical care
(Neurocrit Care)
Vol. 11
Issue 1
Pg. 88-93
( 2009)
ISSN: 1541-6933 [Print] United States |
PMID | 19263250
(Publication Type: Case Reports, Journal Article)
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Chemical References |
- Enzyme Inhibitors
- Methylene Blue
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Topics |
- Aged
- Brain Diseases
(chemically induced, diagnostic imaging)
- Coma
(chemically induced, diagnostic imaging)
- Critical Care
- Enzyme Inhibitors
(adverse effects)
- Glasgow Coma Scale
- Humans
- Male
- Methylene Blue
(adverse effects)
- Parathyroidectomy
- Postoperative Complications
(chemically induced, diagnostic imaging)
- Radiography
- Serotonin Syndrome
(chemically induced, diagnostic imaging)
- Urine
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