Accidental Administration of Ionic Contrast Medium through Intrathecal Route

Derya Gokcinar

doi:10.4172/2161-0495.1000116

Abstract

Context: We report a case of generalized clonic contractions that developed after accidental administration of ionic contrast medium through intrathecal route for computed tomography (CT) cisternography. Non-ionic contrast media can be delivered intrathecally, whereas this route is contraindicated for ionic contrast media. Case details: 31 year-old woman, sodium meglumine ioxitalamate was administered through the intrathecal route, developed convulsions. Eventually she was cured with anticonvulsive agents and supportive treatment. Discussion: Ionic contrast medium should never be administered intrathecally, or else it may cause a lifethreatening neurotoxic reactions.

Highlights

Intrathecal administration of ionic contrast media can trigger neurotoxic reactions due to the media’s hyperosmolar and ionic properties
Diazepam (5 mg) was given intravenously to no avail. Another 5 mg of diazepam was administered, but convulsions continued and the patient was brought to the intensive care unit with generalized clonic contractions and cyanotic and unconscious presentation
No rhinorrhea was observed at the ENT ward; her laboratory findings showed elevated levels of AST, ALT, LDH, CK and CK-MB during the same period

Summary

Introduction

Intrathecal administration of ionic contrast media can trigger neurotoxic reactions due to the media’s hyperosmolar and ionic properties. We discuss a patient who developed convulsions following accidental administration of ionic contrast medium through intrathecal route. During preparation for the procedure, an ionic contrast medium containing sodium meglumine ioxitalamate (Telebrix-35) was administered, instead of a non-ionic contrast medium, through the intrathecal route. Another 5 mg of diazepam was administered, but convulsions continued and the patient was brought to the intensive care unit with generalized clonic contractions and cyanotic and unconscious presentation.

Results

Conclusion