A case of metrizamide encephalopathy--a review of papers in respect of prevention and therapy against major side effects of metrizamide
Takahashi, T.; Nakamura, K.; Tajima, M.
No Shinkei Geka. Neurological Surgery 11(7): 771-779
1983
ISSN/ISBN: 0301-2603 PMID: 6621798 Document Number: 219306
A 64-yr-old man developed a bizarre disturbance of consciousness after a metrizamide cervical myelography with a dose of 3.6 g of iodide. The patient was restless, irritable and asphasic. After treatment with i.v. hydration and compulsive excretion of urine, the patient recovered gradually from this state by 7 h, and gained almost full consciousness by 17 h. Brain CT tremor group show rare complications that must be differentiated from other metabolic diseases. There are always accompanied by other side effects especially by those of the mental, psychiatric change group. The treatment is the same as for the 2nd group. For the prolonged focal neurological deficit group, only 1 case has been reported. There may be no other method than eradication of underlying diseases. The method of prevention of the major side effect was discussed. The amount of contrast media should be restricted to less than 1.8 g iodide and should not be instilled into the cranial cavity. The patients should be better adequately hydrated and premedicated with atropine sulfate and anticonvulsants. Special drugs, such as phenothiazine derivatives and .beta.-blockers must be withdrawn. Special attention must be paid to elderly patients, who are occasionally arteriosclerotic, diabetic, hypertensive, hypoventilatory and have liver and kidney hypofunction.