RT Journal Article
SR Electronic
T1 Neurologic Complications in Diabetics after Metrizamide Lumbar Myelography
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 323
OP 326
VO 7
IS 2
A1 Edward Steiner
A1 Jack H. Simon
A1 Sven E. Ekholm
A1 Janet Erickson
A1 Daniel K. Kido
A1 Shige-Hisa Okawara
YR 1986
UL http://www.ajnr.org/content/7/2/323.abstract
AB Recognized risk factors for metrizamide myelography are seizure disorder, seizurethreshold-lowering drugs, dehydration, and possibly age. After observing serious neurologic complications in diabetic patients after routine metrizamide myelography, a retrospective study was conducted to determine if diabetes should be considered another independent and important risk factor. Forty-one diabetic patients who had lumbar metrizamide myelograms were compared with a control group of 110 nondiabetic patients. A significantly higher incidence was found of severe vomiting (15% vs. 3%, P < 0.01) and neurologic complications (20% vs. 2%, P < 0.001) in the diabetic population. Neurologic complications included one case each of seizure, severe encephalopathy, auditory and visual hallucinations, and prolonged somnolence and four cases of confusion-anxiety. Four of the diabetic patients had major transient elevations of blood pressure. These findings suggest that diabetics are a high-risk population for metrizamide myelography. The dose of metrizamide should be minimized, whenever possible. The new nonionic myelographic agents may prove to be safer in this population, but caution and careful follow-up should be exercised in the initial trials with these patients.