Ahmed I, Pepple R, Jones R P
University of Missouri School of Medicine, Kansas City.
Clin Electroencephalogr. 1988 Jan;19(1):37-42. doi: 10.1177/155005948801900110.
Two cases of absence status are described, one case following metrizamide myelography and the other from omnipaque myelography. Metrizamide has been well known to cause convulsive seizures even in patients without epilepsy. The exact mechanism is not known but appears to be direct neuronal toxic effects possibly due to competitive inhibition of hexokinase activity. The acute confusional state following myelography from water soluble agents is reviewed. In view of the difficulty in clinical diagnosis and the excellent response to anticonvulsant therapy, the possibility of this clinical entity should be specifically excluded by EEG in any person suffering from prolonged confusion following myelography with water soluble agents.
本文描述了两例失神状态,一例发生在甲泛葡胺脊髓造影术后,另一例发生在碘苯六醇脊髓造影术后。甲泛葡胺即使在非癫痫患者中也会引发惊厥发作,这已广为人知。确切机制尚不清楚,但可能是由于对己糖激酶活性的竞争性抑制而产生的直接神经元毒性作用。本文回顾了水溶性造影剂脊髓造影术后的急性意识模糊状态。鉴于临床诊断困难以及对抗惊厥治疗反应良好,对于任何在水溶性造影剂脊髓造影术后出现长时间意识模糊的患者,脑电图应特别排除这种临床情况的可能性。