Lack of efficacy of 5-HT2A receptor antagonists to reduce brain damage after 3 minutes of transient global cerebral ischaemia in gerbils

Serotonin syndrome after therapeutic hypothermia for cardiac arrest: a case series

AIM

To describe causes, manifestations, and diagnosis of serotonin syndrome following therapeutic hypothermia (TH) after cardiac arrest.

METHODS

Retrospective case series from a tertiary academic medical center.

RESULTS

Three male patients suffered witnessed out-of-hospital cardiac arrests and were treated with induced TH. Initial cardiac rhythms included asystole in two and ventricular fibrillation in one. Following completion of rewarming, all three developed neurological signs unexpected for their clinical condition. These included rigidity, hyperreflexia, diffuse tremors, ankle clonus, and marked agitated delirium. Patients also were febrile, hypertensive, and tachycardic. A diagnosis of serotonin syndrome was made in all cases and serotonergic medications were discontinued. All three patients recovered consciousness and two made a full neurological recovery. One patient remained dependent on others for activities of daily living at the time of hospital discharge because of short-term memory impairment.

CONCLUSIONS

Unexpected neurologic findings and prolonged high fever following recovery from TH can be manifestations of serotonin syndrome rather than post-cardiac arrest anoxic brain injury.

Flunarizine enhances functional recovery following sciatic nerve crush lesion in rats

We have used the rat sciatic nerve crush (SNC) injury model to assess the neuroprotective effects of flunarizine (FNZ), a calcium channel antagonist and a vasodilator. The animals were treated with FNZ for various durations following SNC (0.33 mg/kg per day, i.p). Employing the physical disector method, we quantitated the rates of neuron loss in the dorsal root ganglion and spinal cord and protective effects of FNZ. FNZ treatment following SNC reduced neuron loss up to 86.6 and 82.5% in DRG sensory and spinal cord motor neurons, respectively. Functional recovery following SNC with or without FNZ treatment was assessed using the measurements of the total, 1-5 and 2-4-toe spread to quantitate percentage relative toe spread in relation to the respective controls. FNZ provided a superior return of function, i.e. near absolute recovery of both sensory and motor functions in 4 weeks, which is consistent with its neuroprotective effects.