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Journal of Neuroradiology
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le vendredi 23 décembre 2011
Doi : 10.1016/j.neurad.2011.10.006
Neuroimaging findings in a case of fluoxetine overdose
Résultats de l’imagerie dans un cas d’overdose à la fluoxétine
 

Miklós Szólics a, f, Muhammad Chaudhry c, g, Milos Ljubisavljevic d, ⁎ , Peter Corr e, Hashim A. Samir b, Klaus Neidl van Gorkom e
a Neurology Division, Department of Medicine, Tawam Hospital, Al Ain, United Arab Emirates 
b Clinical Imaging Department, Tawam Hospital, Al Ain, United Arab Emirates 
c Tawam Molecular Imaging Center, Al Ain, United Arab Emirates 
d Physiology Department, Faculty of Medicine and Health Science, UAE University, PO Box 17666, Al Ain, United Arab Emirates 
e Radiology Department, Faculty of Medicine and Health Science, UAE University, Al Ain, United Arab Emirates 
f Medicine Department, Faculty of Medicine and Health Science, UAE University, Al Ain, United Arab Emirates 
g Department of Radiology and Radiological Health Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA 

Corresponding author. Fax: +971 37 67 19 66.
Summary

Brain MRI and 18F-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 on 18F-FDG PET/CT performed 37days 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.


Keywords : 18F-FDG PET/CT, MRI, Pallidal necrosis, Serotonin toxicity, Fluoxetine overdose


OutlineMasquer le plan
Introduction
Case report
Neuroimaging findings
Discussion
Conclusion
Disclosure of Interest


© 2011  Published by Elsevier Masson SAS.
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