Hallux Ischemia Observed during the Ergotamine Taking

Arteriopathies due to drug-administration have been described. However, the data is insufficient. Ergotism is caused by ergotamine derivatives intake. It can lead to arterial spasms, causing limb claudication and even distal necrosis in some cases. We report a 42-year-old female patient with a 2-year history of ergot derivatives treatment for migraine attacks. She presented with acute ischemia of the left hallux. She did not take any concomitant medications. Blood test was normal, as well as the arterial Doppler ultrasound of the lower limb. No other cause that could explain this ischemia was present. Discontinuation of ergotamine and vasodilator treatment resolved the ischemia, without sequelae. Physicians should be aware that ergotamine may cause ischemia. Stopping ergotamine is important.