Investig Magn Reson Imaging.  2016 Sep;20(3):196-199. 10.13104/imri.2016.20.3.196.

A Rare Case of Viagra Induced Toxic Encephalopathy

• Jeong SY
• Jeon SJ
• Kim YR
• Choi SS
• Kwak HS

• KMID: 2354802
• DOI: http://doi.org/10.13104/imri.2016.20.3.196

Abstract

Viagra has been prescribed worldwide to treat men with erectile dysfunction. Clinical trials have shown that Viagra may cause various kinds of adverse effects include some central nervous system (CNS) adverse effects. Although extremely rare, toxic encephalopathy also can be one of those effects. This report presents a case of encephalopathy caused by Viagra in correlation with its radiologic findings. Its pharmacologic mechanism and potential effects on the biochemistry of the CNS are reviewed.

Keyword

Viagra; Sildenafil citrate; Toxic encephalopathy; Magnetic resonance

MeSH Terms

Biochemistry
Brain Diseases
Central Nervous System
Erectile Dysfunction
Humans
Male
Neurotoxicity Syndromes*
Sildenafil Citrate*
Sildenafil Citrate

Figure

• 

  Fig. 1 (a) FLAIR image shows symmetric hyperintense lesion in periventricular white matter. (b, c) Lesion shows hyperintense on diffusion and has low ADC value. (d) There is not any enhancement within lesion on postcontrast T1-weighted image.

Reference

1. Viagra U.S. Physician Prescribing Information and U.S. Patient Product Information. Pfizer Laboratories Div Pfized Inc;2015. 09.

2. Milman HA, Arnold SB. Neurologic, psychological, and aggressive disturbances with sildenafil. Ann Pharmacother. 2002; 36:1129–1134.

3. Drug Information for the Health Care Professional. Sildenafil USP DI 2000. 20th ed. Thompson Healthcare;2000. 1:p. 2772–2775.

4. Corbin JD. Mechanisms of action of PDE5 inhibition in erectile dysfunction. Int J Impot Res. 2004; 16:Suppl 1. S4–S7.

5. Review: Could Viagra cause toxic induced encephalopathy? Accessed September 29, 2016. http://www.ehealthme.com/ds/viagra/toxic%20induced%20encephalopathy/.

6. Kang E, Jeon SJ, Choi SS. Uremic encephalopathy with atypical magnetic resonance features on diffusion-weighted images. Korean J Radiol. 2012; 13:808–811.

7. Bathla G, Policeni B, Agarwal A. Neuroimaging in patients with abnormal blood glucose levels. AJNR Am J Neuroradiol. 2014; 35:833–840.

8. Knowles RG, Palacios M, Palmer RM, Moncada S. Formation of nitric oxide from L-arginine in the central nervous system: a transduction mechanism for stimulation of the soluble guanylate cyclase. Proc Natl Acad Sci U S A. 1989; 86:5159–5162.