[Clinical course and CT findings in patients with contrast media-associated seizures]

It is well known that convulsion is one of serious adverse reactions of x-ray contrast media. The occurrence of the convulsion seems to be very rare in general population. However, a few reports noticed recently that patients with brain metastases or gliomas developed this complication relatively frequently and the terms, as contrast-induced convulsion or contrast media-associated (induced) seizure, were used. We performed 12,479 cranial CT examinations with contrast enhancement during the last nine years. The amount of 100 ml in adult or 2 ml/kg in children of 65% Angiografin (methylglucamine diatrizoate) was given intravenously and five patients had contrast media-associated seizures. Case 1: A 37-year-old man with right frontal anaplastic glioma was treated surgically and with radiochemotherapy and hyperthermia. In spite of anticonvulsant therapy, general or left hemiconvulsions occurred sometimes. The patient had contrast-induced general convulsion at 16th CT examination which revealed enhancement in the wall of surgical tissue defect. At 26th CT study, he developed general convulsion again. Case 2: A 47-year-old man with anterior callosal anaplastic glioma was treated surgically and with radiochemotherapy and hyperthermia. After then, he had contrast media-associated general convulsion at 10th CT examination which showed enhanced lesions. Case 3: A 63-year-old woman had been treated surgically for lung cancer. Five years later, CT revealed a ring enhancement in the left frontal lobe. Radiation reduced the lesion gradually.(ABSTRACT TRUNCATED AT 250 WORDS)