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[A case of metrizamide encephalopathy with triphasic waves on EEG]
No to Shinkei = Brain and Nerve
|December 1, 1984
Summary
Metrizamide (Amipaque) contrast medium can cause encephalopathy, a rare complication. This case highlights metrizamide encephalopathy associated with frequent triphasic waves on electroencephalogram (EEG) in a patient undergoing neuroradiological imaging.
Area of Science:
- Neuroradiology
- Neurology
- Toxicology
Background:
- Metrizamide (Amipaque) is a widely used water-soluble, nonionic contrast medium for various neuroradiological procedures.
- While generally considered to have fewer toxic effects than older contrast agents, adverse reactions, including metrizamide encephalopathy, have been reported.
- The occurrence of triphasic waves on electroencephalogram (EEG) during metrizamide encephalopathy is a rare finding, with limited documentation in existing literature.
Observation:
- A 31-year-old male presented with right homonymous hemianopsia prior to a CT scan of the sella turcica.
- The patient underwent tomography of the sella turcica using metrizamide contrast medium injected into the L3-L4 subarachnoid space.
- Following the procedure, the patient developed drowsiness, disorientation, and impaired naming ability, indicative of encephalopathy.
Findings:
- The patient exhibited frequent triphasic waves on EEG, a finding rarely associated with metrizamide encephalopathy.
- The CT scan revealed a partially enhanced isodense mass in the enlarged sella turcica with elevated prolactin levels.
Implications:
- This case underscores the potential for metrizamide-induced encephalopathy, even with modern contrast agents.
- The presence of frequent triphasic waves on EEG may serve as a significant electrophysiological marker for metrizamide encephalopathy.
- Further research is warranted to elucidate the precise mechanisms underlying metrizamide neurotoxicity and its EEG manifestations.