Neuroimaging findings in a case of fluoxetine overdose

Summary Brain MRI and18 F-FDG PET/CT scans were performed in a patient who had survived a suicide attempt by fluoxetine overdose. The patient presented with the following clinical signs and symptoms, and neuroimaging findings: severe signs of serotonin toxicity, including comatose state, akinetic ri...

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Bibliographic Details
Published in:Journal of neuroradiology 2012-10, Vol.39 (4), p.254-257
Main Authors: Szólics, Miklós, Chaudhry, Muhammad, Ljubisavljevic, Milos, Corr, Peter, Samir, Hashim A, van Gorkom, Klaus Neidl
Format: Article
Language:English
Subjects:
18F-FDG PET/CT
Adult
Drug Overdose
Fluorodeoxyglucose F18
Fluoxetine - poisoning
Fluoxetine overdose
Humans
Image Interpretation, Computer-Assisted
Magnetic Resonance Imaging
Male
MRI
Multimodal Imaging
Neuroimaging - methods
Pallidal necrosis
Radiology
Radiopharmaceuticals
Serotonin toxicity
Serotonin Uptake Inhibitors - poisoning
Suicide, Attempted
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Summary:Summary Brain MRI and18 F-FDG PET/CT scans were performed in a patient who had survived a suicide attempt by fluoxetine overdose. The patient presented with the following clinical signs and symptoms, and neuroimaging findings: severe signs of serotonin toxicity, including comatose state, akinetic rigid syndrome and dysautonomia; bilateral globus pallidus changes consistent with extensive pallidal necrosis and subsequent reversible diffuse ischemic changes in white matter, with posterior predominance, involving the splenium of the corpus callosum on brain MRI; and marked hypometabolism in the frontal, parietal and temporal cortical regions as well as in both caudate nuclei on18 F-FDG PET/CT performed 37 days later. These findings suggest that acute severe serotonin toxicity can induce structural and long-standing functional changes in multiple cortical and subcortical brain regions that are associated with cognitive and extrapyramidal syndromes.
ISSN:0150-9861
DOI:10.1016/j.neurad.2011.10.006