metrizamide and Nervous-System-Diseases

Topics: Adult; Analgesia, Epidural; Analgesia, Obstetrical; Bupivacaine; Cranial Nerve Diseases; Female; Humans; Leg; Metrizamide; Middle Aged; Motor Neurons; Nervous System Diseases; Peripheral Nervous System Diseases; Pregnancy; Respiration; Sensation; Spinal Cord; Trigeminal Nerve

Topics: Female; Humans; Male; Metrizamide; Nervous System Diseases; Substance-Related Disorders

Metrizamide neurotoxicity has been hypothesized to be caused by an inhibitory effect of the drug on glucose metabolism. Metrizamide contains a glucose side chain, and glucose analogues including metrizamide have been shown to be inhibitors of hexokinase, an enzyme that is central to cerebral glucose metabolism. We studied the effect of the nonionic contrast agents iohexol, iotrol, and iopamidol, and the ionic contrast meglumine diatrizoate, on hexokinase in vitro. Although metrizamide reproducibly caused competitive inhibition of the reaction, the nonglucose contrast agents had no significant effect on the enzyme. These results add further support for the glucose hypothesis of metrizamide neurotoxicity.

Topics: Contrast Media; Diatrizoate Meglumine; Glucose; Hexokinase; Iohexol; Iopamidol; Metrizamide; Nervous System Diseases; Triiodobenzoic Acids

Two cases of lumbosacral root cysts of different etiology are reported. Their specific radiographic features are described using the combined technique of metrizamide myelography followed by computerized tomography of the spine. The terminology of intraspinal cysts is reviewed and their distinguishing features discussed.

Topics: Cysts; Female; Humans; Male; Metrizamide; Middle Aged; Nervous System Diseases; Spinal Nerve Roots; Tomography, X-Ray Computed

Metrizamide, a major contrast agent for myelographic procedures, has rarely been reported to cause irreversible neurologic complications. The major transient neurologic alterations include neuropsychological reactions, generalized tonic-clonic seizures, and headaches. Two cases of irreversible spinal neurologic deficits resulting from metrizamide myelography are reported, and the factors that may increase the risks of complications in metrizamide myelographic studies are discussed, including preexisting dehydration, patient positioning, and the concentration of contrast agent.

Topics: Adult; Brain Diseases; Headache; Humans; Male; Metrizamide; Middle Aged; Myelography; Nervous System Diseases; Seizures; Vomiting

An investigation was carried out to ascertain if there was a change in visual evoked responses following the intrathecal injection of water-soluble contrast media for myeloradiculography and if this change provided an indication of neurotoxicity as assessed by the onset of headache during a period of 20 h following the radiological examination. The patients were unselected and examined, when facilities for measuring the visual evoked response were available, immediately before and at 1 and 20 h after the examination. Control readings were carried out before, 1 h and 20 h after lumbar puncture in patients who did not have an injection of contrast medium. The first 25 patients in the series received metrizamide; when iopamidol became available a change to the newer medium was made and iopamidol was used on all subsequent patients. All the injections were carried out by the same radiologist and the patients were kept in hospital overnight and interviewed the next morning, avoiding a specific reference to headache unless the patient denied all symptoms. It was found that the latency of the visual evoked response was affected in some cases by the presence of contrast medium in the cerebrospinal fluid and that there was a correlation between the severity of headaches and the delay in the visual evoked response at the 20 h post-myelogram measurement, but not at 1 h after the examination. It would appear, therefore, that the visual evoked response measurement is a valid method of assessing, in the short term, the neurotoxicity of intrathecal water-soluble contrast media and that, on this evidence, iopamidol is less neurotoxic than metrizamide. We are not aware of any long-term complications resulting from the use of either contrast medium.

Topics: Contrast Media; Evoked Potentials, Visual; Headache; Humans; Injections, Spinal; Iopamidol; Iothalamic Acid; Methods; Metrizamide; Myelography; Nervous System Diseases

The tethered conus is probably a rather unknown entity. Every patient, adult or child, with spinal dysraphia, presenting an unexplained progressive urological, neurological and/or orthopedic disturbance can have a tethered cord. With lumbar myelography using metrizamide it is possible to diagnose the low positioned conus and its tethering causes. A review of the clinical symptoms and diagnostic radiology, illustrated with myelographic evidence, is given.

Topics: Adolescent; Adult; Child; Child, Preschool; Female; Humans; Infant; Lipoma; Male; Metrizamide; Myelography; Nervous System Diseases; Paralysis; Sensation; Spina Bifida Occulta; Spinal Cord; Spinal Cord Neoplasms; Syndrome

Topics: Animals; Ataxia; Dog Diseases; Dogs; Female; Male; Metrizamide; Myelography; Nervous System Diseases; Pain; Paralysis

Topics: Adult; Aged; Aphasia; Cognition Disorders; Contrast Media; Female; Humans; Male; Metrizamide; Middle Aged; Movement Disorders; Myelography; Nervous System Diseases; Seizures