Hallucinations iodine

A 70-year-old woman with a history of mastectomy developed syncope which lasted a few seconds. She had taken tamoxifen 10 mg bd for 10 years and had no history of allergic reactions. Doppler ultrasound showed aortic stenosis and coronary angiography was performed using 150 ml of iopromide (a non-ionic contrast medium, iodine 370 mg/ml). She had visual hallucinations (spiders on the wall, moving curtains) 30 minutes after the injection of iopromide. The symptoms resolved 72 hours later without any specific treatment. Neurological and psychiatric examinations were normal, as were brain MRI and Doppler ultrasound of the carotid and vertebral arteries. 

A 64-year-old man with a history of ischemic heart disease underwent coronary angiography with 150 ml of iopromide (iodine 370 mg/ml). One hour later he had visual hallucinations (moving objects, pictures of familiar persons), which resolved about 40 hours later without any treatment. He had taken the following drugs for a year nifedipine 10 mg tds, metoprolol 50 mg bd, and aspirin 325 mg/day. His serum creatinine concentration was in the reference range and there was no history of allergies or previous exposure to contrast media. 

Povidone-iodine (betadine) use in pleurodesis for malignant pleural effusions exhibits a good safety profile pi ]. However, adverse effects of postoperative delirium, hallucinations, transient cognitive impairment occurred following a single application of povidone-iodine to the sternal wound of a cardiac patient. Serum iodine was elevated threefold compared to preoperative levels suggesting caution in use of povidone-iodine [22 ]. 

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