Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023380 (lethargy)
 5,697 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Iotrol, a nonionic dimer isotonic with cerebrospinal fluid at 300 mg l/ml, was evaluated against metrizamide, iopamidol, and iohexol by electroencephalography (EEG) in nonanesthetized cynomolgus monkeys. Each of four monkeys was injected intrathecally with 0.5 ml/kg of 300 mg l/ml of each contrast medium. EEG was obtained before, 45 min, and 3 hr postinjection. EEG spikes, motor disturbances, convulsions, and behavior changes were observed. The EEG from C3 channel was also computer-analyzed. Average percentage differences between control and test energy content of the entire EEG and of the EEG spectrum subdivided into five frequency bands were calculated. With metrizamide, three animals suffered seizures, and all were lethargic and irritable. With iopamidol, two animals convulsed; all animals were lethargic. Transient apathy and motor disturbances were observed in the iohexol animals. No motor or behavior changes were produced by iotrol. Metrizamide and iopamidol increased the spectrum energy in all bands. Neither iohexol nor iotrol affected the EEG significantly. On the basis of these findings, iotrol holds promise as a clinical contrast material for the subarachnoid space.
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PMID:Iotrol, a new myelographic agent: 2. Comparative electroencephalographic evaluation by spectrum analysis. 641 Jul 33

Marked asterixis occurred in two patients following metrizamide myelography. One also suffered generalized seizures and the other had severe stuttering speech for seven days. The spectrum of toxic manifestations of metrizamide is reviewed with emphasis on the unusual lethargy and other depressive effects seen with this relatively safe agent. The hypothesis that metrizamide exerts a ouabain-like effect on the cortical surface was tested. Metrizamide in concentrations as high as 20 mM had no inhibitory effect on rat cerebral K+-para-nitrophenylphosphatase, a partial reaction of (Na+K+)-adenosine triphosphatase. Because metrizamide is a 2-deoxyglucose analogue, a competitive inhibition of hexokinase at the first step in glycolysis was also postulated. Metrizamide was found to competitively inhibit commercial (microbial) hexokinase. The Michaelis constant for glucose rises from 0.13 to 0.25 to 0.33 to 0.91 mM in the presence of 0, 0.4, 1.0, and 2.0 mM metrizamide, respectively. Since the concentration of metrizamide over the cerebral cortex after routine myelography may be approximately 50 mM compared with a glucose concentration of only 3.6 mM (65 mg/dl), it is postulated that impaired brain glucose metabolism may be responsible for some of the toxic effects of metrizamide.
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PMID:Asterixis and encephalopathy following metrizamide myelography: investigations into possible mechanisms and review of the literature. 722 1