Reversible cerebral vasoconstriction syndrome and monoamine oxidase inhibitors

To the Editor: Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by multiple acute-onset severe headaches, with or without acute neurologic deficits or seizures, and diffuse segmental narrowing of cerebral arteries that mostly resolves spontaneously within a few months. The exact pathophysiology of RCVS is not fully explored. A transient failure in the control of cerebral arterial tone with sympathetic hyperactivity and vasoconstriction seems to be crucial. This alteration may occur spontaneously or may be evoked by various endogenous and exogenous factors.5,6 We describe the occurrence of RCVS in 2 patients taking monoamine oxidase (MAO) inhibitors in the absence of other potential causes of RCVS.