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MYELOGRAPHY with metrizamide (Amipaque) is an increasingly popular technique useful in the evaluation of radiculopathy. The most common neurologic side effects are headache, nausea, vomiting, and dizziness.1-3 More serious neuropsychiatric side effects reported include confusional states, hallucinations, sleep disturbances, agitation, and other signs of altered mental status.1-5 These changes have been reported as brief, lasting less than 48 hours, and benign in outcome.
We report a case, the first, to the best of our knowledge, in which the symptoms appearing after metrizamide myelography were severe and prolonged. A brief discussion of the etiology and treatment of these side effects follows the case presentation.
Report of a Case
A 56-year-old woman had a three-year history of low back and right leg pain precipitated by a minor injury. After an exacerbation of the pain that was not relieved by 14 days of bed rest, she was admitted to the hospital.
Elliott RL, Wild JH, Snow WT. Prolonged Delirium After Metrizamide Myelography. JAMA. 1984;252(15):2057–2058. doi:10.1001/jama.1984.03350150057022
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