The Aword

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In 1982, Avrahami and Cohen ([1]) published an article in German concerning post-myelography headaches persisting for more than 6 months.

The authors suggested that these were the result of residual Pantopaque causing blood vessel irritation.

At this stage, various articles (e.g.[2]) raised the issue of contaminants from gloves and glass etc. being introduced into the spinal fluid inadvertently.

There were suggestions that these contaminants acted synergistically with Pantopaque to cause arachnoiditis.

Was this an attempt to draw attention away from the toxicity of the dye itself?

By now, Lafayette's Newton, in his role as R&D (Research and Development) Director, had become anxious to consult Alcon's legal department, about correspondence he had been receiving regarding his position for handling medical complaints.

Some of this centred on an article by Haughton and Ho, published in the June 1982 edition of the journal Radiology ([3]).

Haughton had conducted animal studies to compare the effects of the new dye, Amipaque (Metrizamide), with iophendylate with regard to the effect on the arachnoid membrane.

The authors noted that

"the arachnoiditis produced by iophendylate was more severe than that produced by Metrizamide; the iophendylate also produced a more cellular reaction that was qualitatively different from the reaction to Metrizamide"

and noted that this had clinical implications should the dye not be completely removed after the examination. One notes that Newton had in fact provided

Haughton with vials of Pantopaque for use in his primate studies.

[1] Avrahami E, Cohn DF. Schweiz Arch Neurol Neurochir Psychiatr. 1982; 131(2): 157-60. [The problem of postmyelography headaches]


[2] Williams AG, Seigel RS, Kornfeld M, Whorton JA. AJNR Am J Neuroradiol 1982 Mar-Apr; 3(2): 121-5 Experimental production of arachnoiditis with glove powder contamination during myelography.

[3] Haughton VM, Ho KC. Radiology 1982 Jun; 143(3): 699-702 Arachnoid response to contrast media: a comparison of iophendylate and metrizamide in experimental animals.