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Acute and delayed cerebral infarction after wasp sting anaphylaxis
J E Riggs1, L M Ketonen, J P Wymer
1Department of Neurology, West Virginia University School of Medicine, Morgantown, USA.
Clinical Neuropharmacology
|August 1, 1994
Summary
A severe wasp sting reaction caused delayed stroke in a 52-year-old man. This case suggests a link between anaphylaxis and cerebrovascular events via sympathetic nervous system pathways.
Area of Science:
- Neurology
- Immunology
- Vascular Medicine
Background:
- Anaphylaxis, a severe allergic reaction, can have systemic effects.
- Wasp stings are a common trigger for anaphylaxis.
- Delayed neurological complications following anaphylaxis are rare but serious.
Observation:
- A 52-year-old man experienced severe anaphylaxis post-wasp sting.
- He developed transient neurological deficits including slurred speech and left hemiparesis.
- Later, he presented with obtundation and quadriparesis, with angiographic evidence of bilateral internal carotid artery occlusions.
Findings:
- The patient's severe anaphylactic reaction was followed by delayed ischemic stroke.
- Angiography revealed near-complete to complete occlusion of both internal carotid arteries.
- A proposed mechanism involves cerebrovascular sympathetic innervation disruption following anaphylaxis.
Implications:
- This case highlights a potential mechanism for delayed ischemic stroke after insect sting anaphylaxis.
- Understanding this link may improve the management of anaphylaxis patients at risk for neurological complications.
- Further research into the neuro-immunological pathways of anaphylaxis is warranted.