J. M. OHAR, M.D.; A. A. FOWLER, M.D.; J. B. SELHORST, M.D.; F. L. GLAUSER, M.D.
To the editor: Two articles (1, 2) have attributed the neurologic complications of intravenous nitroglycerin therapy to thiamine deficiency or alcohol intoxication. The absence of a history of nutritional deprivation leaves the claim of Wernicke's encephalopathy induced by alcoholic diluents suspect (3). We have further cause to doubt this explanation.
We have seen a patient who over 6 hours progressively developed headache, vomiting, bradycardia, loss of consciousness to include coma, and asymmetric third cranial nerve palsies during a trial of intravenous nitroglycerin infusion for pulmonary hypertension. We attributed these neurologic abnormalities to increasing intracranial pressure, which is reported in cats,
OHAR JM, FOWLER AA, SELHORST JB, GLAUSER FL. Intravenous Nitroglycerin Administration and Ethanol. Ann Intern Med. ;102:558–559. doi: 10.7326/0003-4819-102-4-558_2
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Published: Ann Intern Med. 1985;102(4):558-559.
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