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February 1981

Postmyelographic Asterixis-Reply

Author Affiliations

Albert Einstein Medical Center Northern Division York and Tabor roads Philadelphia, PA 19141

Arch Neurol. 1981;38(2):136. doi:10.1001/archneur.1981.00510020094022

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In Reply.—  Metrizamide (Amipaque) myelography performed by the Department of Radiology at the Albert Einstein Medical Center, Philadelphia, follows a standard protocol. Patients are excluded from study with metrizamide if they have a history of seizures, chronic alcoholism, or recent phenothiazine use. Patients are instructed to force oral fluids until two hours before their myelogram, and premedication with secobarbital sodium is given parenterally. Lumbar myelography with metrizamide is performed under fluoroscopic control. The contrast material is injected via lumbar puncture using a disposable, 22-gauge, short-bevel spinal needle. Following the injection of 12 mL metrizamide into the subarachnoid space, the needle is removed. During the study, the patient's head is elevated, and after the completion of the study, the head is elevated from 15 to 30° for eight hours; the patient then remains in a supine position for another 16 hours. In addition, the nursing staff is instructed to continue to force oral

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