To the Editor.
—The neurotoxieity of metrizamide is well known and has been reported again in two articles in the January 1985 issue of the Archives.1,2In my experience, the incidence of toxicity to metrizamide can be significantly lowered and perhaps eliminated by removing most, if not all, of the metrizamide visible at fluoroscopy at the termination of myelography, whether this be for lumbar or cervical examination. I leave the needle in during the filming and then remove the dye in much the same fashion as was done with iophendylate (Pantopaque). I use either a No. 20 or a No. 22 needle. The progress of dye removal can be checked periodically by placing the syringe under the fluoroscope. By this procedure, I have observed no serious reaction to metrizamide in over 300 myelograms.
Lourie H. Toxicity of Metrizamide. Arch Neurol. 1985;42(11):1036. doi:10.1001/archneur.1985.04060100014006
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