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Status epilepticus and seizures induced by iopamidol myelography

Karl Martin Klein1, Kiyoshi Shiratori, Susanne Knake

  • 1Interdisciplinary Epilepsy-Center, Department of Neurology, Philipps-University Marburg, Marburg, Germany.

Seizure
|March 11, 2004
PubMed
Abstract

Insights

Iopamidol myelography can trigger seizures, including status epilepticus (SE), particularly in patients with epilepsy or when performed in the cervical region. The overall seizure incidence in non-epileptic patients was 0.15%.

Area of Science:

  • Neurology
  • Radiology
  • Pharmacology

Background:

  • Iopamidol is a non-ionic contrast agent used in myelography.
  • Myelography involves injecting contrast into the spinal canal to visualize the subarachnoid space.
  • Epilepsy is a neurological disorder characterized by recurrent seizures.

Observation:

  • This study investigated seizures and status epilepticus (SE) following iopamidol myelography.
  • A retrospective analysis of 1350 procedures over 5 years was conducted.
  • The impact of cervical versus lumbar myelography on seizure risk was examined.

Findings:

  • Two non-epileptic patients experienced generalized tonic-clonic seizures.
  • One patient with symptomatic epilepsy developed prolonged SE after cervical myelography.
  • The incidence of seizures in non-epileptic patients was 0.15%.
  • Cervical myelography showed a higher seizure induction rate than lumbar myelography.

Implications:

  • Iopamidol myelography carries a risk of seizure induction, especially in patients with epilepsy and during cervical procedures.
  • Informed consent regarding seizure risk is crucial for patients undergoing iopamidol myelography.
  • Further research may explore preventative strategies for seizure induction during myelography.

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