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Bilateral papillitis associated with Cafergot® therapy

Toxic manifestations from ergotamine therapy may result from overdose or from unusual susceptibility of the individual.' Such toxic effects as paresthesias, localized edema and itching, substernal distress, and vertigo due to vascular spasm are well known.2 At times, more serious complications such as thrombophlebitis and gangrene have been reported.* Cerebral symptoms consisting of confusion, lethargy, and convulsions occur rarely, again probably on a vascular ischemic basis. In this article, a patient is described who developed bilateral papillitis following the use of CafergotB (a combination of ergotamine and caffeine) for headache. It is suggested that ischemia of the optic nerve head was responsible for the clinical picture.