Myelography Induced Fatal Complications; Seizure and Rhabdomyolysis

Cha, Ki Chul; Kim, Jae Hoon; Moon, Byung Gwan; Kang, Hee In; Lee, Seung Jin

Abstract

Myelography has been generally regarded as a safe procedure. However, epidural hematoma and some allergic reactions have been reported, although rarely, as complications of myelography. Herein, we report a patient who experienced seizure and rhabdomyolysis after iopamidol injection with a review of the pertinent literature. A 75-year-old man with no medical history of seizure underwent lumbar spine myelography for the evaluation of the lumbar spine stenosis. After several hours following injection with water-soluble nonionic contrast medium(Iopamidol), he had a generalized tonic-clonic seizure, which progressed into a complex partial. In spite of the efforts of injecting anti-seizure medications, intermittent short-lasting seizure activity continued for hours and brain computed tomographic scan showed a large amount of hyperdense iopamidol in the subarachnoid space. As a consequence, he suffered from rhabdomyolysis-induced acute renal failure. The patient recovered from the contrast-induced acute renal failure after several days of treatment in the intensive care unit and hemodialysis. Fatal complications, such as seizure and rhabdomyolysis, can occur after myelography. Prompt diagnosis and treatment are needed.