Diazepam prophylaxis of contrast media-induced seizures during computed tomography of patients with brain metastases
Journal Article
·
· AJR, Am. J. Roentgenol.; (United States)
- Univ. of Texas System Cancer Center, Houston
The effect of 5 mg of intravenous diazepam (Valium) on contrast media-associated seizer incidence was studied in a randomized controlled trial involving 284 patients with known or suspected brain metastases undergoing cerebral computed tomography. Of these patients, 188 were found to have brain metastases, and it is estimated that for this subgroup prophylactic diazepam reduces the risk of contrast-assocated seizure by a factor of 0.26. Seizures occurred in three of 96 patients with metastases on diazepam and in 14 of 92 patients with metastases but without diazepam. Factors related to increased risk of contrast media-associated seizures are: (1) prior seizure history due to brain metatases and/or prior contrast, (2) progressive cerebral metastases, and (3) prior or concurrent brain antineoplastic therapy. Factors not related to an increased risk of these seizures are: (1) contrast media dosage, chemical composition, or osmolarity, (2) computed tomographic appearance of metastases, and (3) type of primary malignancy. Concomitant therapeutic levels of diphenylhydantoin (Dilantin) do not protect completely against contrast media-associated seizures. Pathophysiology of contrast media-associated seizures is discussed in view of the risk factors determined by this study.
- OSTI ID:
- 5293849
- Journal Information:
- AJR, Am. J. Roentgenol.; (United States), Journal Name: AJR, Am. J. Roentgenol.; (United States) Vol. 140:4; ISSN AAJRD
- Country of Publication:
- United States
- Language:
- English
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550602 -- Medicine-- External Radiation in Diagnostics-- (1980-)
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62 RADIOLOGY AND NUCLEAR MEDICINE
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BODY
BRAIN
CENTRAL NERVOUS SYSTEM
COMPUTERIZED TOMOGRAPHY
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560306* -- Chemicals Metabolism & Toxicology-- Man-- (-1987)
62 RADIOLOGY AND NUCLEAR MEDICINE
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
BODY
BRAIN
CENTRAL NERVOUS SYSTEM
COMPUTERIZED TOMOGRAPHY
CONTRAST MEDIA
DIAGNOSTIC TECHNIQUES
DISEASES
DRUGS
MEDICINE
METASTASES
NEOPLASMS
NERVOUS SYSTEM
ORGANS
PATIENTS
PREVENTIVE MEDICINE
SIDE EFFECTS
TOMOGRAPHY