BACKGROUND Contrast-induced encephalopathy (CIE) is a rare complication of cardiac catheterization; clinical manifestations include cortical blindness, seizures and focal neurological deficits. In general, recurrent epileptic seizures following cardiac catheterization with iodixanol occur more rarely than do other complications. CASE PRESENTATION Here, we report a case of a 76-year-old male patient who experienced unstable angina for nearly 10 months and was admitted to our hospital. Repeat cardiac catheterization was performed using iodixanol. At approximately 20 h after the first cardiac catheterization, his upper limbs began to exhibit slight trembling; the patient was conscious and could not control these movements. A total of 6 episodes occurred before the second cardiac catheterization was performed, with each episode lasting approximately 2 s. These symptoms were not treated. At approximately 2 h after the second cardiac catheterization, the symptoms became more severe, and the frequency of the episodes increased significantly; the symptoms had fully subsided at 6 h after the second operation. An electroencephalogram (EEG) demonstrated diffuse slowing with epileptiform abnormalities. Paroxysmal spike-wave and slow wave discharges were observed in the bilateral areas, and the abnormalities were marked in the frontal areas. These observations led us to conclude that the patient was experiencing epileptic seizures. During 6 months of monthly clinical follow-up visits after discharge, no abnormalities of the nervous system were found by cardiologists or neurologists, and the patient's EEG was normal. No antiepileptic drugs were administered throughout this process. CONCLUSIONS CIE, especially recurrent epileptic seizures, is a rare but often reversible complication of cardiac catheterization with iodixanol. Its symptoms can be mild and therefore are easily ignored by physicians. Early CIE detection may be achieved by EEG. Repeated exposure to contrast agents carries the risk of recurrent epileptic seizures.

中文翻译：

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碘克沙醇心脏导管插入术后复发性癫痫发作：一例。

背景技术造影剂脑病（CIE）是心脏导管插入术的一种罕见并发症。临床表现包括皮质盲，癫痫发作和局灶性神经功能缺损。通常，用碘克沙醇进行心脏导管插入术后复发性癫痫发作比其他并发症少见。病例介绍在这里，我们报告一例76岁的男性患者，该患者经历了近10个月的不稳定型心绞痛并入院。使用碘克沙醇重复进行心脏导管插入术。第一次心脏导管插入术后约20小时，他的上肢开始出现轻微的颤抖。病人有意识，无法控制这些动作。在进行第二次心脏导管插入术之前，总共发生了6次发作，每集持续约2 s。这些症状未得到治疗。在第二次心脏导管插入后约2小时，症状变得更加严重，发作频率显着增加。在第二次手术后6小时，症状完全消失。脑电图（EEG）显示弥漫性减慢并伴有癫痫样异常。双侧出现阵发性尖峰波和慢波放电，额叶异常明显。这些观察结果使我们得出结论，该患者正在发生癫痫发作。出院后每月进行6个月的临床随访，心脏病专家或神经科医生未发现神经系统异常，患者的EEG正常。在整个过程中未服用任何抗癫痫药。结论CIE，尤其是反复发作的癫痫发作，是一种罕见的但经常可逆的碘克沙醇心脏导管插入术并发症。它的症状可能很轻微，因此很容易被医生忽略。EEG可以实现早期CIE检测。反复接触造影剂会导致癫痫发作反复发作的风险。