A 61-year-old man visited the Emergency Department complaining of dysarthria about 1 h after taking more than 30 sildenafil tablets with the intention to commit suicide. Dysarthria and dizziness were observed, but there were no other neurological symptoms. The creatine kinase level was elevated to 3118 U/L, and the patient was diagnosed with rhabdomyolysis. Brain magnetic resonance imaging revealed multiple scattered acute cerebral infarctions in both midbrain artery branches. At 4 h post-intoxication, the dysarthria had improved and we initiated dual antiplatelet therapy for cerebral infarction. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians should be able to anticipate and treat complications like cerebral infarction and rhabdomyolysis after sildenafil intoxication.
方法:一名61岁的男子在服用超过30片西地那非片剂并打算自杀后约1小时内到急诊科就诊,抱怨构音障碍。观察到构音障碍和头晕,但没有其他神经症状.肌酸激酶水平升高至3118U/L,患者被诊断为横纹肌溶解症。脑磁共振成像显示两个中脑动脉分支中多发性散见性急性脑梗死。在中毒后4小时,构音障碍得到改善,我们开始对脑梗死进行双重抗血小板治疗.为什么急诊医生应该意识到这一点?:急诊医生应该能够预测和治疗西地那非中毒后的脑梗死和横纹肌溶解症等并发症。