Ropper A H, Chiappa K H, Young R R
Ann Neurol. 1979 Sep;6(3):222-6. doi: 10.1002/ana.410060308.
A prospective study was made of changes in the electroencephalogram after the use of metrizamide for myelography and posterior fossa cisternography in 61 patients (62 studies). The EEG changed in 21 patients (34%); 3 of these had had previously abnormal records, and the abnormalities were accentuated on the second recording. Eight developed paroxysmal activity, including spike and wave in 1. EEG changes appeared 24 to 48 hours after the use of metrizamide in 6 patients whose intervening EEGs were normal. The percentage of records that changed tended to increase as metrizamide was brought to more rostral levels. Symptoms following the use of metrizamide were reviewed in 58 patients. Although there were no seizures in the present series, seizures did occur with subsequent use of metrizamide in 3 other patients at our institution. Previous reports may have underestimated the frequency of EEG changes after metrizamide since these may require 24 to 48 hours to develop. The appearance of such activity suggests that the use of metrizamide in patients with known seizure disorders, the anatomical level to which metrizamide is brought during radiography, removal of contrast medium, and further investigation of premedication with anticonvulsants all require careful consideration when use of metrizamide is being contemplated.
对61例患者（62次检查）在使用甲泛葡胺进行脊髓造影和后颅窝脑池造影后脑电图的变化进行了前瞻性研究。21例患者（34%）脑电图发生改变；其中3例既往脑电图记录异常，再次记录时异常加重。8例出现阵发性活动，其中1例出现棘波和慢波。6例脑电图在使用甲泛葡胺前正常的患者，脑电图改变出现在用药后24至48小时。随着甲泛葡胺注入到更高的头端水平，脑电图改变的记录比例有增加趋势。对58例患者使用甲泛葡胺后的症状进行了回顾。虽然本系列中未发生癫痫发作，但在我们机构，另外3例患者随后使用甲泛葡胺时确实发生了癫痫发作。既往报告可能低估了甲泛葡胺后脑电图改变的发生率，因为这些改变可能需要24至48小时才会出现。这种活动的出现表明，在考虑使用甲泛葡胺时，对于已知有癫痫疾病的患者使用甲泛葡胺、造影时甲泛葡胺到达的解剖水平、造影剂的清除以及对抗惊厥药预处理的进一步研究都需要仔细考虑。
