Status epilepticus and seizures induced by iopamidol myelography.

Abstract

PURPOSE:

To report that iopamidol myelography can induce status epilepticus (SE) in patients carrying the diagnosis of symptomatic epilepsy and to estimate the incidence of seizures in patients undergoing iopamidol myelography.

METHODS:

We retrospectively identified all patients with seizures/SE associated with 1350 iopamidol myelographies during the last 5 years at our institution. The impact of cervical versus lumbar myelography was analysed.

RESULTS:

Induced by iopamidol myelography two non-epileptic patients suffered from first generalised tonic-clonic seizures and a 67-year-old women with symptomatic epilepsy after a remote ischemic stroke developed a generalised tonic-clonic seizure evolving into a dialeptic and right nystagmus SE (i.e. complex focal status) of 5-hour duration. The incidence of seizures in non-epileptic patients was 0.15%. The incidence of seizure induction for lumbar myelography was lower than for myelographies that included the cervical subarachnoid space.

CONCLUSIONS:

Iopamidol myelography (especially if cervical) is associated with a risk of seizures in non-epileptic individuals and can induce SE in patients with epilepsy. Patients should be informed about the risk of seizure induction.

• Authors: Karl Martin Klein, Kiyoshi Shiratori, Susanne Knake, Hajo M Hamer, Brita Fritsch, Anelia Todorova-Rudolph, Felix Rosenow
• Journal: Seizure (Seizure) Vol. 13 Issue 3 Pg. 196-9 (Apr 2004) ISSN: 1059-1311 [Print] England
• PMID: 15010060 (Publication Type: Case Reports, Journal Article, Review)

Chemical References

• Iopamidol

Topics

• Aged
• Electroencephalography (methods)
• Female
• Humans
• Iopamidol (adverse effects)
• Myelography (adverse effects)
• Seizures (chemically induced, physiopathology)
• Status Epilepticus (chemically induced, physiopathology)