Generalized Motor Seizure following Metrizamide Cisternography

Metrizamide is a water-soluble contrast medium used as a diagnostic tool in myelography and cisternography. Despite its accepted safety, its use has been associated with generalized motor seizures, and several cases of this toxicity have been reported. Risk factors include phenothiazine ingestion, seizure history, and large doses of the contrast material. Abnormal electroencephalographic wave patterns, as well as seizure activity, are less frequent after cisternography than myelography. A case of a metrizamide-induced generalized motor seizure following cisternography is reported in a patient with none of the above risk factors. The need for a thorough medication history and the use of prophylactic anticonvulsants in selected patients is discussed.