Brachial artery stenosis secondary to ergotism and responsive to nifedipine

Ergotism is an uncommon drug reaction that may lead to severe ischemic vasoconstriction, which is usually unilateral and more commonly involves the lower extremities. Successful therapeutic measures have included invasive vascular surgery and the use of various available intravenous and oral vasodilators. Reported here is the case of a 56-year-old woman with Marfan's syndrome and chronic migraine headaches who presented with upper extremity pulselessness that responded promptly to oral nifedipine (Procardia). This relatively inexpensive agent with potent peripheral arterial vasodilative properties appears to be the agent of choice in severe ergotamine poisoning.