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December 1979

Implication of Metrizamide Myelography

Author Affiliations

Department of Neurology University of New Mexico School of Medicine Albuquerque, NM 87131

Arch Neurol. 1979;36(13):859. doi:10.1001/archneur.1979.00500490073015

To the Editor.—  Metrizamide is known to pass over the convexities1 of the brain and to penetrate into the cortex.2 Headache, nausea, vomiting, nuchal rigidity, EEG abnormalities, seizures, rarely hyperacusis, hallucinations, and agitation have been reported after metrizamide myelography.3-5 I have observed another possibly related adverse reaction.

Report of a Case.—  Pain developed in the back and right leg of a 22-year-old man. The only finding was a sensory deficit in an L-5 distribution on the right. Otherwise, he was healthy, was taking no medication, and had no history of allergy.An hour before performance of lumbar myelography, he received 75 mg of meperidine hydrochloride and 0.4 mg of atropine intramuscularly. The procedure was performed with 6.75 g of metrizamide diluted to 16 cc. A narrow dural sac and a herniated disk at L4-5 were found.During the next several hours, a headache developed and the patient

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