Whereas the epidemic form of
ergotism has been rare in the 20th century, the sporadic form has a wide distribution as a consequence of
therapy with ergot-derivative drugs. Favourable prognosis of the condition, with complete recovery from the ischemic peripheral circulatory disorders can be obtained by early diagnosis. Precise evaluation of the history, with recognition of treatment of
migraine headache or
postpartum hemorrhage with
ergot alkaloids, can be determinative in diagnosis. The specific pattern of the angiographic findings, as we saw it in 6 cases within the last 4 years, decisively confirms the diagnosis. We could demonstrate thread-, thorn- and hour glass-like narrowing of the vessels, due to
spasm. Total occlusion with the development of collaterals may occur, but we saw no
thrombus formation. The stenotic arterial segments had smooth margins. The distribution of the involved arteries was more focal than generalized and more peripheral than central. In two cases
spasm could be abolished immediately by a
pharmaceutical (i.a. injection of
tolazoline) or by
anesthetic procedures (
halothane). The phenomenologic data, together with the complete reversal of the circulatory ischemic disorders after
therapy (particularly the absolute ban of ergots) in most cases, is so specific that other diseases of ischemic nature (emboli,
arteriosclerosis,
Buerger's disease, fibromuscular
hyperplasia) can be excluded.