J Korean Acad Rehabil Med.  1998 Dec;22(6):1347-1351.

Central Nervous System Involvement in Eosinophilia-Myalgia Syndrome Associated with L-tryptophan Ingestion: A case report

• Lee CH
• Lee SH
• Kim SJ

Abstract

We report a case of Eosinophilia- Myalgia syndrome with central nervous system (CNS) involvement following ingestion of the essential amino acid, tryptophan. The Eosinophilia- Myalgia syndrome can be diagnosed when there is a severe myalgia and peripheral eosinophilia in the absence of other diseases causing eosinophilia. This condition has been associated with the ingestion of the tryptophan in many cases, but the amount and duration of ingestion have been yet to be elucidated. Although many cases have been reported, few cases involved the CNS. We present a 28 year- old male who complained of a severe myalgia and disorientation after taking the taken tryptophan for 2 weeks. Thorough examination revealed the peripheral eosinophilia, vasculitis on brain MRI, abnormal VEP, and muscle atrophy on muscle biopsy. Symptoms improved with the steroid pulse after discontinuation of the tryptophan.

Keyword

Eosinophilia-Myalgia syndrome; Central nervous system involvement; Tryptophan

MeSH Terms

Biopsy
Brain
Central Nervous System*
Eating*
Eosinophilia
Eosinophilia-Myalgia Syndrome*
Humans
Magnetic Resonance Imaging
Male
Muscular Atrophy
Myalgia
Tryptophan*
Vasculitis
Tryptophan