metrizamide and Reflex--Abnormal

A 23-year-old man, involved in a motor-vehicle accident, became quadraparetic due to cervical spinal cord injury at the C-4 to C-6 level. Five months later he was noted to have bilateral, asymmetric pupillary mydriasis precipitated by elevation and stretch of an arm or leg. Pharmacologic pupillary testing and ciliospinal reflex responses suggested that the oculosympathetic pathways were intact. Computed tomographic myelography using metrizamide disclosed a posttraumatic syringomyelic cyst at C-4. This pupillary phenomenon has been termed oculosympathetic spasm, and we reviewed four previous reports. While the cause of oculosympathetic spasm remains speculative, it may represent a localized form of autonomic hyperreflexia.

Topics: Accidents, Traffic; Adult; Humans; Male; Metrizamide; Quadriplegia; Reflex, Abnormal; Reflex, Pupillary; Spinal Cord; Spinal Cord Injuries; Sympathetic Nervous System; Syringomyelia; Tomography, X-Ray Computed

Topics: Adult; Female; Humans; Metrizamide; Myelography; Quadriplegia; Reflex, Abnormal

Topics: Animals; Blood Pressure; Cats; Contrast Media; Coronary Angiography; Diatrizoate; Heart Diseases; Heart Rate; Lidocaine; Mechanoreceptors; Metrizamide; Reflex, Abnormal

In a 32-year-old female areflexia occurred after thoraco-lumbar myelography with metrizamide (Amipaque), instead of the hyperreflexia usually found as a side effect of subarachnoid water-soluble contrast media. A direct neurotoxic effect on the cauda equina seems to have been the cause.

Topics: Adult; Female; Humans; Metrizamide; Myelography; Reflex, Abnormal; Time Factors

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