Acute encephalopathy associated with anaphylactic shock caused by angiographic radiocontrast media: An unusual case

Abstract

Radiocontrast media have been used with increasing frequency for centuries. Radiocontrast media may have the spectrum up to anaphylaxis as a side effect. The case presented here is of a patient with acute encephalopathy, associated with the anaphylactic shock of angiographic radiocontrast media. A 67-year old male patient with a diagnosis of abdominal aortic aneurysm (AAA) was referred for coronary and peripheral angiographic evaluation before the AAA operation. After the angiographic examination was completed, the patient developed complaints of dyspnea, stridor, flushing and eruption. The patient recovered totally after a successful medical intervention was performed for anaphylaxis. Decorticated posture gradually developed, and the patient lost consciousness again. After cranial computed tomography, diffusion magnetic resonance imaging and electroencephalography were performed, levetiracetam treatment was started to the patient after the patient had a tonic-clonic convulsion. The patient recovered completely after a seizure with antiepileptic treatment without. Nonconvulsive status epilepticus must be considered after the allergic reaction, and anti-epileptic agents should be taken into consideration in addition to preventing hypoxia and hypoperfusion.