Danger in the Use of Intrathecal Methylene Blue

Abstract

Methylene blue has been used for some years to reveal the presence of block within the ventricular system. Information gained from the procedure has been considered valuable, the drug harmless. Reactions were considered anaphylactic in type. Experimental observations emphasize, however, that the untoward effects are akin to phenomena resulting from the intrathecal administration of alcohol. The dye becomes fixed to neural tissue and the subsequent course is irreversible. Efforts to drain and irrigate the spinal subarachnoid space have failed to control or relieve the process. In patients there is bilateral optical atrophy, anosmia, and quadriplegia; the lower extermities become flaccid and paralyzed. Dementia has been noted.