Complex partial status epilepticus following myelography with metrizamide

Area of Science:

• Neurology
• Neuroradiology
• Epileptology

Background:

• Myelography is an imaging technique used to visualize the spinal cord.
• Metrizamide is a non-ionic contrast agent historically used in myelography.
• Complex partial status epilepticus is a prolonged seizure event affecting consciousness and motor function.

Observation:

• Two patients experienced complex partial status epilepticus post-metrizamide myelography.
• Clinical presentation included confusion and complex motor symptoms.
• Electroencephalograms (EEGs) revealed independent ictal activity across both cerebral hemispheres.

Findings:

• The status epilepticus resolved rapidly with antiepileptic drug administration.
• No neurological sequelae were observed in either patient at follow-up.
• Both patients had pre-existing, non-specific EEG abnormalities, but no prior seizure history.

Implications:

• Metrizamide myelography may precipitate seizures in susceptible individuals.
• Prompt recognition and treatment of status epilepticus are crucial for favorable outcomes.
• Understanding the relationship between contrast agents and neurological events is vital for patient safety.