Abstract

BACKGROUND
Synthetic corticosteroids are commonly utilized in interventional pain management procedures. These substances have potential side-effects including psychological adverse events.
OBJECTIVE
We describe a case of substance-induced psychotic disorder resulting from corticosteroids administration.
DESIGN
Case Report.
METHODS
We describe a 67-year-old male that, six months prior to being consulted at our center, received a cervical epidural, 4 level medial branch blocks, 4 trigger point injections and a tendon injection in the shoulder all including corticosteroids all in one treatment session.
RESULTS
Approximately 7 days following the multiple injections, the patient developed psychotic episodes including racing thoughts, anger, agitation, pressured hyperverbal speech and paranoia. The symptoms spontaneously resolved in approximately 7-10 days.
DISCUSSION
Although well known as a potential complication, corticosteroid induced psychosis secondary to interventional pain procedures have never been reported. We further discuss this potential side effect of utilizing corticosteroids and emphasize the need for guidelines regarding steroid utilization.

Links

Publisher Full Text

Authors

Benyamin RM, Vallejo R, Kramer J, Rafeyan R

Institution

Millennium Pain Center, Bloomington, IL 61701, USA. benyamin@millenniumpaincenter.com

Source

Pain physician 11:6 pg 917-20

MeSH

Adrenal Cortex Hormones
Aged
Aggression
Anger
Anti-Inflammatory Agents
Cervical Vertebrae
Domestic Violence
Drug Administration Schedule
Humans
Injections, Epidural
Male
Methylprednisolone
Myofascial Pain Syndromes
Neck Pain
Nerve Block
Paranoid Personality Disorder
Psychoses, Substance-Induced
Time Factors
Triamcinolone

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

19057637