iothalamate-meglumine and Seizures

Topics: Cerebral Angiography; Coma; Contrast Media; Electroencephalography; Female; Humans; Iothalamate Meglumine; Middle Aged; Migraine Disorders; Seizures

A patient with thrombotic thrombocytopenic purpura had a seizure as the result of a contrast media injection given during computed tomographic examination. To our knowledge, ours is the first such case reported.

Topics: Contrast Media; Female; Humans; Iothalamate Meglumine; Middle Aged; Purpura, Thrombotic Thrombocytopenic; Seizures; Tomography, X-Ray Computed

Results of initial clinical trials of brain tumor chemotherapy after osmotic blood-brain barrier disruption are promising. In general, the procedure is well tolerated. The major complication has been seizures. In this report, data are presented which indicate that the etiology of these seizures is related to the use of contrast agent (meglumine iothalamate) to monitor barrier modification. A series of 19 patients underwent a total of 85 barrier modification procedures. Documentation of barrier disruption was monitored by contrast-enhanced computed tomographic (CT) scanning, radionuclide brain scanning, or a combination of both techniques. In 56 procedures (19 patients) monitored by enhanced CT, seizures occurred a total of 10 times in eight patients. Twenty-three barrier modification procedures (in nine of these 19 patients) documented by nuclear brain scans alone, however, resulted in only one focal motor seizure in each of two patients. In eight of the 19 patients who had seizures after barrier disruption and enhanced CT scan, four subsequently had repeat procedures monitored by radionuclide scan alone. In only one of these patients was further seizure activity noted; a single focal motor seizure was observed. Clearly, the radionuclide brain scan does not have the sensitivity and spatial resolution of enhanced CT, but at present it appears safer to monitor barrier modification by this method and to follow tumor growth between barrier modifications by enhanced CT. Four illustrative cases showing methods, problems, and promising results are presented.

Topics: Adult; Blood-Brain Barrier; Brain; Brain Neoplasms; Carotid Artery, Internal; Child; Drug Therapy, Combination; Female; Humans; Iothalamate Meglumine; Male; Mannitol; Methotrexate; Middle Aged; Osmosis; Pentetic Acid; Radionuclide Imaging; Seizures; Technetium; Technetium Tc 99m Pentetate; Tomography, X-Ray Computed

Topics: Adult; Arteriovenous Malformations; Humans; Iothalamate Meglumine; Male; Myelography; Seizures; Spinal Cord; Tomography, X-Ray Computed

The effect of hydration on the incidence of complications from myelography with aqueous media was studied. Myelography was performed with methylglucamine iocarmate in dehydrated and vigorously hydrated monkeys. The incidence of seizures and the severity of arachnoiditis were significantly greater in the dehydrated animals. The authors suggest that patients be permitted fluids ad lib. prior to myelography with aqueous media, or in some cases be given fluids intravenously.

Topics: Acute Disease; Animals; Arachnoiditis; Chronic Disease; Haplorhini; Iothalamate Meglumine; Macaca; Myelography; Seizures; Water

Conray (meglumine iothalamate), the contrast media frequently used in shuntograms for diagnosing malfunctioning ventriculo-peritoneal shunts, will occasionally cause severe muscular spasms and seizures. In this article, the authors describe anesthetic and critical care management of a case with this complication.

Topics: Anesthesia, Inhalation; Anesthesia, Intravenous; Cerebrospinal Fluid Shunts; Child; Diazepam; Female; Humans; Hyperventilation; Iothalamate Meglumine; Muscle Spasticity; Pancuronium; Positive-Pressure Respiration; Seizures; Thiopental

A new water-soluble myelographic contrast agent with more hydrophilic properties than metrizamide was developed and tested in the primate (Macaca mulatta) and the cat. A new animal model that allows study of the convulsive effects of intrathecally administered contrast agents in the awake monkey was designed. With this sensitive model the new contrast agent was shown to have a remarkable reduced convulsive effect when compared with metrizamide and other media. Intrathecal hypertonic solutions in the cat depress the evoked cortico-spinal responses whereas the neurotoxic effects of the iodinated water-soluble contrast media increase them. The net effect is a combination of the two actions.

Topics: Animals; Cats; Cerebral Cortex; Haplorhini; Hypertonic Solutions; Iothalamate Meglumine; Macaca mulatta; Metrizamide; Myelography; Reflex; Seizures; Spinal Cord

Convulsions and fracture of the neck of the femur following myelography with Conray and Dimer X are reported in two patients with a gross post-tuberculous gibbus deformity of the thoracic spine. The possible causes of the increased risk associated with myelography of the patients with gibbus are discussed.

Topics: Femoral Neck Fractures; Humans; Iothalamate Meglumine; Male; Middle Aged; Myelography; Seizures; Spinal Diseases

We have taken myelograms of six patients with grave post-tuberculous thoracic gibbus of the spine and gross deformity of the thoracic cage. Two of these patients suffered violent convulsions and fracture of the neck of the femur. In one patient the myelogram was taken with Conray Meglumine and in another with Dimer X. We suggest that a grave deformity of the thoracic cage is a relative contraindication for lumbar myelography with these water-soluble contrast media. We assume that the reduced tissue oxygenation in these patients results in a lower threshold for convulsions.

Topics: Femoral Neck Fractures; Humans; Iothalamate Meglumine; Metrizamide; Myelography; Seizures; Spinal Diseases; Spine

The water-soluble contrast medium, N-methylglucamine iothalamate (NMGI), when injected in a dose of 1 ml into the cerebral parenchyma space of dogs (Feldberg's method), diffused within the lateral ventricle at a constant rate of flow against the nerve fibers running therein. Such was recorded by X-ray television and 16 mm cinecamera. Injection of the same dose into the subarachnoid space, however, did not produce these phenomena. Differences in the mode of transfer from brain to heart as the result of three different sites of application (ventricle, parenchyma and subarachnoid space) were investigated using 131I labeled NMBI, the determination of radioactivity being made by two scintillation detectors situated at the head and the heart. The determination of RI activity revealed that the above mentioned three areas of brain have their own characteristic pattern of attenuation from brain to heart, particularly in the case of subarachnoid application. Clonic convulsions after intracranial administration of NMGI in dogs occurred when NMGI was given into the parenchyma but not when given into the ventricle.

Topics: Animals; Brain; Cerebral Ventricles; Contrast Media; Dogs; Female; Injections; Injections, Intraventricular; Iodine Radioisotopes; Iothalamate Meglumine; Iothalamic Acid; Male; Mice; Myocardium; Rabbits; Radiography; Rats; Seizures; Subarachnoid Space

Selective left vertebral angiography was carried out in 21 rabbits comparing the toxic effects of meglumine iothalamate (Conray meglumine), meglumine metrizoate (Isopaque Cerebral) and metrizamide (Amipaque). The iodine concentration for all 3 media was 280 mg/ml. General convulsions were seen in many of the animals with all 3 media. The convulsions occurred at higher doses and were milder with metrizamide than with the 2 other contrast agents. Bradycardia was also seen with all 3 media and there was no statistical significant difference between them in this respect. The mortality was approximately 50% with both meglumine iothalamate and meglumine metrizoate, while no animals died following angiography metrizamide.

Topics: Angiography; Animals; Bradycardia; Contrast Media; Female; Injections, Intra-Arterial; Iodobenzoates; Iothalamate Meglumine; Male; Metrizamide; Metrizoic Acid; Rabbits; Seizures; Vertebral Artery

An experimental method for testing contrast media for myelography was developed and used to compare three watersoluble contrast media, iocarmate meglumine, iothalamate meglumine and metrizamide after suboccipital myelography in 120 rabbits. A further 71 rabbits served as controls. Iocarmate and iothalamate caused vigorous convulsions; metrizamide did not. Examination of the CSF revealed an acute pleocytosis after installation of the contrast media and after cisternal puncture with injection of hypertonic saline. Histological examination of the spinal cord, nerve roots and meninges revealed pathological changes in 1 or 32 unoperatec controls (3%). Leucocyte infiltrations were found in the meninges, nerve roots and spinal cord of about 20% of the animals after myelography, after cisternal puncture without injection or with injection of hypertonic saline. There were no significant quantitative differences between the experimental groups. Degenerative changes were seen only after myelography. No meningeal fibrosis was demonstrated. An abnormal leucocyte count in the primary CSF influenced the incidence of histological changes, indicating that only rabbits with CSF cell counts within normal limits should be used in future experiments.

Topics: Animals; Cerebrospinal Fluid; Contrast Media; Iodobenzoates; Iothalamate Meglumine; Iothalamic Acid; Leukocyte Count; Metrizamide; Myelography; Paralysis; Rabbits; Reflex, Abnormal; Seizures

Topics: Adolescent; Adult; Brain Diseases; Electroencephalography; Female; Humans; Iothalamate Meglumine; Myelography; Seizures; Time Factors; Unconsciousness

Although Dimer X is said to be a low toxic water soluble contrast medium, epileptic seizures sometimes occur during or after Dimer X ventriculography. The toxicity of this dye was examined in rats and possible prophylactic measures were evaluated. From the results of our experiment it was concluded that Dimer X of low concentration should be used with premedication of Valium and Decadron.

Topics: Animals; Cerebral Cortex; Dexamethasone; Diazepam; Injections, Spinal; Iothalamate Meglumine; Iothalamic Acid; Rats; Seizures; Tremor

In an attempt to study the use and value in ventriculography of meglumine iocarmate (Dimer-X), previously accepted as a water soluble contrast medium safe for myelography, we have conducted animal experiments to compare Dimer-X with megulumine iothalamate (Conray 60) and meglumine diatrizoate (Angiografin). We also made clinical studies of Dimer-X. In the animal experiments, 1.5 ml and 2.0 ml of Dimer-X were injected into the ventricles of 7 dogs. We noted the apparent superiority of Dimer-X over Conray 60 and Angiografin as far as side effects were concerned, but there were no particular differences in the intensities of the ventriculograms obtained. Morphological studies of the ventricles and histological examinations of the ventricular walls 1 month after intraventricular injections of Dimer-X showed no abnormalities. In the clinical studies, ventriculography with 1-5 ml Dimer-X, performed on 17 cases, aged 8 months to 62 years, with diseases of the central nervous system, produced ventriculograms of good diagnostic value with no side effects, such as convulsions, apart from mild headache or vomiting in 4 instances.

Topics: Animals; Cerebral Ventricles; Cerebral Ventriculography; Child; Contrast Media; Dogs; Electroencephalography; Female; Humans; Infant; Iothalamate Meglumine; Iothalamic Acid; Male; Middle Aged; Myoclonus; Seizures

The reaction of the rats to injection of Dimer-X into the intracranial subarachnoid space or the cerebrum was examined. When 28% iodine Dimer-X was injected into the subarachnoid space, 7 of 10 rats showed agitation, which is the most severe complication, and all died within one hour. All of the reactions were reduced with the lower concentrations of Dimer-X. The rats which were premedicated with Valium and/or Decadron revealed fewer and less severe complications. It is believed that the intracerebral injection method has many disadvantages, the results of its experiment are therefore reported without further elaboration. From the results of the experiment it is concluded as follows: 1) Dimer-X should not be injected into the intracranial subarachnoid space. 2) Dimer-X of low concentration in the subarachnoid space reduces the complications. 3) Complications from the subarachnoid application of Dimer-X can be reduced by premedication with Valium and Decadron.

Topics: Animals; Behavior; Cerebral Ventriculography; Female; Iothalamate Meglumine; Iothalamic Acid; Male; Rats; Seizures; Subarachnoid Space; Tremor

A case is presented of convulsions, subarachnoid haemorrhage and death following the use of meglumine iothalamate 280 for myelography. The patient was suffering from sciatica but had no pre-existing symptoms of other neurological disease. This case dramatically illustrates the dangers inherent in the use of meglumine iothalamate 280 for myelography.

Topics: Humans; Iothalamate Meglumine; Iothalamic Acid; Male; Middle Aged; Myelography; Sciatica; Seizures; Subarachnoid Hemorrhage

The adverse effects in a series of 50 lumbar myelographies with Amipaque were compared with those in a corresponding series, examined with Dimer-X. Side effects occurred in 58% of the cases examined with Amipaque and in 68% of the Dimer-X series. No seizures occurred in 58% of the cases examined with Amipaque and in 68% of the Dimer-X series. No seizures occurred in either series but slight fibrillations of fasciculations appeared in 2 Dimer-X patients. Hyperreflexia of the legs was recorded in 22% of the Amipaque and in 36% of the Dimer-X cases. Other adverse reactions to the media were mild to moderate. Some burst activity, but no definite paroxysmal abnormality was noted in EEG recordings in 2 Amipaque cases. The low epileptogenicity of Amipaque has ensured a wider safety margin of lumbar myelography.

Topics: Adult; Aged; Brain; Diazepam; Drug Evaluation; Electroencephalography; Female; Fever; Headache; Humans; Iodobenzoates; Iothalamate Meglumine; Iothalamic Acid; Lumbosacral Region; Male; Metrizamide; Middle Aged; Myelography; Nausea; Pain; Premedication; Seizures

In a comparative study between Dimer X and Amipaque (metrizamide) for lumbar myelography it was found that there is a little higher frequency of monor, but unimportant side effects after Amipaque. Amipaque has also been used for thoracocervical myelography with excellent results and without greater discomfort than after myelography in the lumbar region. A new puncture technique was used for the eximation of the cervical region alone: lateral puncture on the neck between the laminae of C1 and C2 under TV control. In more than 75 reinvestigations no arachnoid changes were observed.

Topics: Adult; Aged; Female; Fever; Headache; Humans; Iodobenzoates; Iothalamate Meglumine; Iothalamic Acid; Lumbosacral Region; Male; Metrizamide; Middle Aged; Myelography; Nausea; Neck; Seizures; Subarachnoid Space; Surveys and Questionnaires; Urination Disorders; Vomiting

Lumbar myelography with dimeglumine iocarmate was performed in 90 cases premedicated with diazepam (Valium). EEG was performed before, as well as 3 and 24 hours after myelography. The use of diazepam interfered to some extent with the interpretation of the EEG. In 3 cases EEG abnormalities occurred 3 hours after myelography, most probably ascribable to Dimer-X. No further changes were found in the 24-hour recording. Immediate side effects were few and mild and seizures did not appear. The EEG abnormalities were equally distributed among patients with and without side effects.

Topics: Adolescent; Adult; Aged; Electroencephalography; Female; Headache; Humans; Iothalamate Meglumine; Iothalamic Acid; Male; Middle Aged; Myelography; Nausea; Pain; Seizures; Time Factors

Topics: Animals; Cats; Contrast Media; Electroencephalography; Injections, Intraventricular; Iothalamate Meglumine; Metrizamide; Seizures; Solubility; Water