Status epilepticus and seizures induced by iopamidol myelography.
OBJECTIVE
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.
Klein
Karl Martin
KM
Interdisciplinary Epilepsy-Center, Department of Neurology, Philipps-University Marburg, Marburg, Germany.
Shiratori
Kiyoshi
K
Knake
Susanne
S
Hamer
Hajo M
HM
Fritsch
Brita
B
Todorova-Rudolph
Anelia
A
Rosenow
Felix
F
D000368:Aged; D004569:Electroencephalography / Q000379:methods; D005260:Female; D006801:Humans; D007479:Iopamidol / Q000009:adverse effects*; D009192:Myelography / Q000009:adverse effects*; D012640:Seizures / Q000139:chemically induced* / Q000503:physiopathology; D013226:Status Epilepticus / Q000139:chemically induced* / Q000503:physiopathology
D007479:Iopamidol