Seizures following myelography with iopamidol

Levey, Aĺlan I.; Weiss, Howard D.; Yu, Robert K.; Wang, Henry E.; Krumholz, Allan

doi:10.1002/ana.410230416

Cited by 27 publications

(7 citation statements)

References 12 publications

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“…This can be exemplified by the rare epileptogenic effect of iopamidol in man (3,4,8). This very rare excitative/convulsive effect of iopamidol has been consistently revealed by the present animal model, both in this study and previously (7), only at the maximum dose/volume of 1.0 mllkg b.w., whereas the injection of 0.5 mllkg (2.6 times the maximum recommended clinical myelographic dose in the USA) failed to disclose this effect both previously (7) and in this study.…”

Section: Discussionsupporting

confidence: 84%

Neural Tolerance of the Non-Ionic Dimers Iodixanol and Iotrolan and the Non-Ionic Monomer Iopamidol during Myelography in Non-Anaesthetised Rabbits

et al. 1995

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and 2Department of Toxicology, Research and Development, Nycomed Imaging AS, Oslo, Norway. AbstractPurpose: The neural tolerance of the recently introduced dimer iodixanol (320 g Ill) was compared with that of the dimer iotrolan (300 g III) and of the monomer iopamidol (300 g Ill), both used in clinical myelography.Material and Methods: Non-anaesthetised rabbits were injected into the cisterna magna with Ringer's solution (control) or contrast media (CM) at doses of 1.0 or 0.5 ml/kg b.w. The behaviour of the animals (10 in each of 7 groups) was evaluated for signs of excitation and depression during the first 3 hours after injection.Results: At the dose level of 1.0 ml/kg b.w., iodixanol produced no seizures but did cause focal twitching in 4/10 rabbits. Iopamidol produced grand mal seizures in 2/10 and hyperexcitability in 4/10 rabbits. Iotrolan produced generalised grand mal seizures in 8/10 rabbits, an incidence of excitation significantly greater than that of iodixanol (p

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Section: Discussionsupporting

confidence: 84%

Neural Tolerance of the Non-Ionic Dimers Iodixanol and Iotrolan and the Non-Ionic Monomer Iopamidol during Myelography in Non-Anaesthetised Rabbits

et al. 1995

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“…uchiyama et al 33 found elevated concentration of CSF iodine in their index case and not in 4 control cases, supporting evidence of a temporary breakdown of the blood-brain barrier. The cause of the blood brain barrier disruption is variably attributed to the hyperosmolality and chemotoxicity of contrast media 2,16,21,28,[43][44][45][46][47][48][49][50][51][52][53][54][55][56] . Studies suggest that contrast media penetrates the blood-brain barrier as a function of dosage, contact time, concentration of anions in the material, and lipophilic…”

Section: Resultsmentioning

confidence: 99%

Persistent Neurological Deficit from Iodinated Contrast Encephalopathy following Intracranial Aneurysm Coiling

Leong

Fanning²

2012

Interv Neuroradiol

109

148

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Neurotoxicity from iodinated contrast agents is a known but rare complication of angiography and neurovascular intervention. Neurotoxicity results from contrast penetrating the blood-brain barrier with resultant cerebral oedema and altered neuronal excitability. Clinical effects include encephalopathy, seizures, cortical blindness and focal neurological deficits. Contrast induced encephalopathy is extensively reported as a transient and reversible phenomenon. We describe a patient with a persistent motor deficit due to an encephalopathy from iodinated contrast media administered during cerebral aneurysm coiling. This observation and a review of the literature highlights that contrast-induced encephalopathy may not always have a benign outcome and can cause permanent deficits. This potential harmful effect should be recognised by the angiographer and the interventionalist.

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“…The manufacturer recommends that 10 mL of the 300 mg/mL strength or 15 mL of the 200 mg/mL strength be utilized for this procedure (12). A case report utilizing the dose administered to our patient also reported an outcome of generalized tonicclonic seizure in a patient with no history of seizure disorder (13).…”

Section: Discussionmentioning

confidence: 62%

Iopamidol-Induced Meningoencephalopathy in an Hiv-Seropositive Patient

Stroup¹,

Stephens²,

Baker³

2007

Baylor University Medical Center Proceedings

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Central nervous system infectious and metabolic abnormalities are common in HIV-positive patients. Drug therapy, opportunistic infections, the clinical course of HIV disease itself, and very rarely iodinated radiographic contrast agents can all be linked to these abnormalities. The following case describes an HIV-seropositive patient who developed encephalopathy after undergoing a cervical myelogram that utilized iopamidol dye (Isovue-M 300 mg/mL).

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Seizures following myelography with iopamidol

Cited by 27 publications

References 12 publications

Neural Tolerance of the Non-Ionic Dimers Iodixanol and Iotrolan and the Non-Ionic Monomer Iopamidol during Myelography in Non-Anaesthetised Rabbits

Neural Tolerance of the Non-Ionic Dimers Iodixanol and Iotrolan and the Non-Ionic Monomer Iopamidol during Myelography in Non-Anaesthetised Rabbits

Persistent Neurological Deficit from Iodinated Contrast Encephalopathy following Intracranial Aneurysm Coiling

Iopamidol-Induced Meningoencephalopathy in an Hiv-Seropositive Patient

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