To the Editor.
—The article by Killebrew et al1 mentioned neurologic complications following the use of metrizamide during cervical myelography. The authors suggested that there have been only six cases of delayed adverse psychiatric reaction, one with spinal seizure and one with tonic-clonic seizure, of approximately 250 myelograms, and that there is an increased likelihood of adverse neuropsychiatric reactions when the contrast medium is permitted to enter the cranial cavity (as with cervical myelography).I personally know of at least two cases of transient adverse mental status changes in patients under my care at the authors' institution. The changes occurred after routine metrizamide myelography in the lumbar region, and neither was included in this series. Therefore, I seriously question the relevance of the incidence and frequency of this problem based on the authors' data, which is obviously incomplete.The important point seems to be that adverse transient mental disturbances
Mahaley MS. Metrizamide Myelography Complications. Arch Neurol. 1984;41(2):137–138. doi:10.1001/archneur.1984.04050140035016