Unilateral Leg Edema, Migraine, and Methysergide

A patient who was taking methysergide maleate for migraine headaches had painless unilateral leg edema as the only symptom of retroperitoneal fibrosis. Unilateral obstruction was present but asymptomatic in the upper urinary tract. Extrinsic pelvic venous obstruction without intravascular thrombosis was the cause of the edema. Treatment, consisting of surgical release of the vein and discontinuance of the drug therapy, resulted in a prompt and satisfactory response. Marked arterial narrowing was also present but was not apparent on an aortogram.