Myodil Action Group (UK)

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Index Page 2

Please note:
When referring to Myodil, Pantopaque, and Ethiodan, they are marketing names given to the chemical Iophendylate which is one of the contrast mediums used in myelograms.

Pictures and Diagrams
This page contains pictures and diagrams which help to explain in a graphic nature the devastating effects that Myodil has on the spinal cord. Also the chemical composition of Myodil.

Information on Iophendylate Patent

1942: Steinhausen conducted his doctoral thesis (funded by Eastman Kodak) on Iophendylate. He conducted tests on Rats and Dogs to compare the affects of Lipiodol with Iophendylate. The tests showed that Iophendylate had the same affect on the spinal cord as Lipiodol, he discovered cysts in the arachnoid layer which he attributed to a foreign body reaction. Nevertheless, in his paper, Steinhausen concluded ?With the assurance from these experimental studies that the new medium was safe." (Link to journal article on Burton Report).

1942: Van Wagenen (a neurosurgical colleague of Warrens, at the University of Rochester) identified Iophendylate as causing chemical meningitis in 30 patients. Van Wagenen states the severity of the chemical meningitis in closed spaces such as those created by a tumour is worse with Iophendylate than Lipiodal. (Link to Van Wagenens speach on Dr. Burtons website)

FDA Hand Written Letter to Walter Van Winkle about Lafayette's Pantopaque (1943)
This is a hand written letter which I believe was sent from a FDA investigator to Walton Van Winkle regarding the dangers associated with Lafayette's  Pantopaque (Myodil).  I have published the original letter, but is very difficult to read so I have typed it out again underneath but there are words which are illegible, I have typed in red what I think they are.

A letter from Walton Van Winkle of the FDA to Lafayette (1944)
Van Winkle expresses concerns about quality control during manufacturing of Pantopaque, adverse reactions of animal tests and reports of the same in Humans.  He was also unhappy about the lack of testing for free Iodine in the product and other concerns.  These issues were never resolved.

1944, A letter from R.P. Herwick M.D. Chief of Drug Division, FDA to Lafayette granting permission for the marketing of Pantopaque.

Tests on Dogs which died within ten Minutes, 1950
A paper by Dr. Rudolph Jaeger published in the Journal "Archives of Neurology and Psychiatry," about Iophendylate (Pantopaque) tests carried out on dogs, the dogs suffered severe reactions to Pantopaque and were dead within ten minutes.

Death of a Man Caused by Severe Reaction to Myodil, 1952
Short report in The British Medical Journal dated 30th August 1952 about a man who's death was caused by severe epileptic fits due to a reaction to Myodil.

Death of a Man Within 15 Months of Undergoing a Myelogram, 1953
A case study written by Dr. Theodore C. Erickson and Dr. Hans J. van Baaren published in the Journal of the American Medical Association describing a case study of a man who underwent a Pantopaque Myelogram, the Pantopaque entered his cranium and triggered a severe reaction, causing his death within 15 months of undergoing the procedure.

Experimental Data and Case Studies 1954
Summary of experimental data and case studies by Dr. Everett F. Hurteau, Dr. William C. Baird, and Dr. Ernest Sinclair, published in The Journal of Bone and Joint Surgery. The report shows the damage Pantopaque caused to to the brains of test dogs, and concludes that the assumption that Pantopaque aspirates naturally is wrong.

Lancet Article 1956
This is a study carried out at Middlesex Hospital in the UK by Dr. Davies on 119 patients who had all undergone Myodil Myelograms and were all suffering Adhesive Arachnoiditis as a result of their Myelogram.

Death of a Man Within Seven Months of Undergoing a Iophendylate (Pantopaque) Myelogram, 1962
A case study written by Dr. Michael S. Mason and Dr. John Raaf and published in an American medical journal, the Journal of Neurosurgery. The case study concludes that the patient died as a result of the procedure.

1962: A report by ARJUN D. SEHGAL, M.D., W. JAMES GARDNER, M.D. and DONALD F. DOHN, M.D. published in the Cleveland Clinic Quarterly.  The investigators admit that Pantopaque causes Adhesive Arachnoiditis but claim that patients' symptoms can be relieved using cortisone injections. [Ed: We now know this relief was probably short lived because epidural injections also cause Adheive Arachnoiditis] (Link to report)

1965: Case report by Morton Swartz M.D. and Philip Dodge M.D. of a 61 year old woman who died of Obliterative Arachnoiditis with hydrocephalus one year after cervical myelography using Iophendylate. (Link to Journal article)

Death of a Man Within Five Years of Undergoing a Myelogram, 1966
A case study written by Dr. James H Greig and Dr. Norman Wignall, and published in a Canadian medical journal "The Journal of the Canadian Association of Radiologists" about a man who underwent a Pantopaque Myelogram, after his death a postmortem was carried out and his spinal cord examined, severe Adhesive Arachnoiditis was discovered.

Unpublished Walker Hound Tests Conducted by Lafayette Pharmacal, 1969
The documents detail a 15 week intrathecal toxicity study comparing the effect of Pantopaque I and Pantopaque II on the spinal cords of Walker Hound dogs. Pantopaque I was already being produced and marketed by Lafayette Pharmacal, Pantopaque II was developed with the hope that it would be easier to remove from the spinal cord after Myelography.  The investigation concluded that Pantopaque I and II produced granulomatis meningitis in all of the dogs. These test results were never made available to the FDA or published publicly.

FDA warning to Lafayette, 1969
Two letter's from the FDA to Lafayette pharmaceutical in which the FDA criticizes Lafayette for not providing regular reports on Pantopaque, and also the FDA ordered Lafayette to change the labeling of Pantopaque and to include warnings of severe reactions it causes, namely Adhesive Arachnoiditis.  

1971: A report by Ronald G. Clark, Ph.D., Thomas H. Milhorat, M.D., Walter C. Stanley, Ph.D., and Giovanni Di Chiro, M.D., published in the Journal of Neurosurgery, please note no copy is available at this time. It documents a study carried out on Beagle dogs in which Pantopaque is injected in to the Sub-Arachnoid space in the dogs' spinal cords. The researchers conclude that the effects of Pantopaque on the spinal cord are greatly understated by previous research findings and that Pantopaque actually has a devastating effect on the animals tested. (Link to journal)

1972. Glaxo change product packaging documents to include reference to removal of Myodil after Myelography. 1973, Glaxo again change product packaging documents advising Myodil be aspirated after Myelography.  This same year they also advised that if low back pain and sciatica symptoms persisted to inject hydrocortisone sodium succinate intrathecally, which is now known to be an extremely dangerous procedure which also involved a cocktail of chemicals that would probably have accelerated the onset of Adhesive Arachnoiditis.  (Link to Hansard record where this information can be found)

Tests on Rats 1973
A study conducted by J. K. Jakobsen and published in the medical journal: Acta Radiologica, in which the spinal cords of rats are injected with Iophendylate and Methiodal to determine the effects of the procedure, 55 rats die immediately, the rest are sacrificed at later dates and examined.  The study concludes that Iophendylate causes meningitis and Adhesive Arachnoiditis even if the contrast medium is removed after the procedure.

Myodil License Application, 1974
Glaxo's 1974 application for Product License of Right to produce and market Myodil in the UK and abroad, in which they admitted Myodil caused Adhesive Arachnoiditis, was this the License to Kill?

1974: A report by Dr. A.J. Keogh published in the medical journal: Clinical Radiology. Meningeal reactions seen with Myodil Myelography: Four cases of a meningeal reaction giving a characteristic radiographic appearance with Iophendylate injection B.P. (Myodil) Myelography are reported. Steroids seem to have helped in two of these cases. Mention is made of a review of symptoms in a further 111 cases. The morbidity associated with Myodil may be higher than has previously been appreciated. (Link to abstract).

1976: A report by Dr. W. Ward, Dr. M. Matheson, and Dr. A. Gonski, published in the Medical Journal of Australia, please note no copy is available at this time. Three cases of Arachnoiditis after use of oil based media in Myelography are presented. The study concludes at that time Iophendylate (Myodil) is the best contrast media for use in Myelography, however it's use causes serious problems such as pain and disability and therefore should be avoided. (Link to journal)

Arachnoiditis Risk After Myelography, 1978
A short article by Dr. Henry L. Feffer on the high risk of Arachnoiditis after Iophendylate Myelography.

1978: An investigation carried out by Drs. Zawirski M, Szapiro J, Doli?ski A, Kun M, Polis Z. and published in the Polish medical journal Pol Przegl Radiol Med Nukl., please note no copy is available at this time. The title of the report is: [A trial of evaluation of the diagnostic usefulness and safety of Ethiodan (Myodil), Conray 60 and dimer X in cerebral ventriculography (author's transl)]. British Drug Houses were given sole rights to sell Myodil in Canada under the marketing name Ethiodan. (Link to journal title)

1978: An article by Dr. Burton published in the medical journal: Spine, please note no copy is available at this time. One hundred patients with lumbosacral adhesive Arachnoiditis documented either directly at surgery or by unequivocal Myelography served as the basis for this report on the pathologic process. The entity appears not to be rare, as previously thought, but common in patients with severe back and/or leg pain and functional incapacitation due to the failed back surgery syndrome. The importance of Pantopaque in contributing to this disease process appears to be quite significant. (Link to journal)

1978: A report by Dr. John D. H. Johnston and Dr. Joetta B. Matheny published in the medical journal: Spine, please note no copy is available at this time. The results of a long-term study of 28 patients operated on for adhesive lumbar Arachnoiditis are presented. The technique involved was microscopic lysis of adhesions. The first case of surgery was performed in 1966 and the last, in 1970, with follow up through 1976. Numerous observations are made regarding the clinical picture and the appearance of Arachnoiditis at the time of surgery. Some conclusions are drawn regarding the causes of this condition with some emphasis on the role of Pantopaque, multiple surgeries, and other trauma. (Link to journal)

1980: A case study by Dr. M.K. Greenberg and Dr. S. C. Vance published in the medical journal The Lancet. Describing how tiny droplets of Iophendylate entered the cranium and caused focal seizures which lead to loss of consciousness. (Link to journal)

1980: Report of a case and review of the causes of postoperative convulsions due to iophendylate (Myodil). A 58-year-old man underwent a Myodil Myelogram, postoperatively convulsions occurred. Large quantities of intracranial iophendylate (Myodil) were seen on postoperative skull X-rays. (Link to journal)

Tests on 16 Monkeys 1982
An article by Dr. Victor M. Haughton and Dr. Ho Khang-Cheng published in the medical journal: Radiology, it describes tests on Monkeys comparing the effects of Iophendylate and Metrizamide (Amipaque) which is a water based contrast media.

1983: In response to increasing competition from other products (Amipaque, Metrizamide etc.) Alcon stepped up their marketing campaign by advertising directly to physicians stating, "Pantopaque has been used for several million Myelograms and the incidence of side effects has been extremely low." This is evidence of the huge number of Pantopaque Myelograms that have been performed in America alone since the introduction of the product, as well as the manufacturers blatant disregard of the truth about Adhesive Arachnoiditis.

1984: June 1984, a message was sent from Hazleton to Alcon requesting Alcon's permission to publish an article about the clinical disease and death in rabbit pyrogen studies using intravenous Pantopaque (which were not as damning as the intrathecal dog study). Alcon's response is illustrative of the blatant disregard the company had of statutory and ethical requirements of them (and leaves us under no illusion as to their motive): " R&D does not support publication by Hazleton, it cannot benefit Alcon in any way and may prove to be damaging to our product." Documents relating to the rabbit studies are not available at this time.

1984: A report by Johansen JG, Barthelemy CR, Haughton VM, Lipman BT, Ho KC. A study on monkeys to test the hypothesis that blood entering the spinal cord when injecting Myodil is responsible for the formation of Adhesive Arachnoiditis. They found that Arachnoiditis was as severe after Myelography alone as after Myelography and laminectomy. Minimal Arachnoiditis was found myelographically and histologically after myelography with metrizamide 300 mg l/ml, and severe Arachnoiditis was found after Myelography with Iophendylate whether or not laminectomy was performed. Laminectomy alone produced insignificant arachnoid changes. Experimental Myelography preceding laminectomy did not increase the risk of Arachnoiditis. Please note no copy is available at this time but here is a link to the abstract (Link to journal)

1985: A report by Dr. B. Baessler and Dr. R. Lahl in a German medical journal Zentralblatt fur Neurochirurgie. Case reports of three people who underwent Myelograms, two had Amipaque injected in to their spinal cords and one had Pantopaque. All three people suffered severe reactions, one of the Amipaque cases died within 17 days of the procedure and the Pantopaque case died within 13 days of the procedure. Please note no copy is available at this time but here is a link to the abstract (Link to journal).

Report by Dr. Burton
This is a report by an American spinal specialist, Dr. Burton, it describes the problems caused by Pantopaque Myelograms and the process of Adhesive Arachnoiditis.  This report was never accepted for publication. Please note this takes a few moments to download since it is a large file.

1988: An article by Dr. R.M. Pascuzzi, Dr. K.L. Roos, and Dr. J.A. Scott. published in the medical journal Epilepsia, please note no copy is available at this time. A 46-year-old woman developed focal seizures 10-15 years following Iophendylate Myelography. Focal epileptogenic abnormalities on electroencephalogram corresponded to the localization of residual Iophendylate in the right sylvian fissure. Intra cranial Iophendylate may have produced chronic meningeal reaction leading to cortical irritation and a chronic seizure disorder. (Link to journal)

Long Range Prognosis of Arachnoiditis 1989
An study by Dr. D.W. Guyer, Dr. Leon L. Wiltse, Dr. Marjoire L. Eskay, and Dr. Betsy H. Guyer published in the medical journal: Spine. A long term study on 50 patients who all suffered with Arachnoiditis and had undergone Pantopaque Myelography examinations.

A report for your GP, 1990
An article by Dr. I. H. J. Bourne in the Journal of the Royal Society of Medicine, written for GP's as opposed to specialists such as Neurologists, with the aim of describing Adhesive Arachnoiditis.

Dr. John M Stevens article, Imaging of the Spinal Cord 1995
Dr. Stevens writes a lengthy article on the various techniques used for obtaining images of the spinal cord. He criticises Myodil as being a cause of Adhesive Arachnoiditis.

Letter from St Mary's Hospital, 1995
This letter discusses the publication of a research paper in the medical journal Neuroradiology. The paper documents the investigation in to the prevalence of Adhesive Arachnoiditis following back surgery and whether the patient underwent a Myelogram or not before surgery, and how this will have increased the likelihood of Arachnoiditis. The paper concludes there is greater risk of Arachnoiditis after surgery where Myelography has also been used. (Link to journal)

Dr Susan Parisian's expert report condensed, 2002
This is a document showing the major points from the comprehensive research report published in 2002 by Dr. Susan Parisian about the production, testing, and use of Pantopaque. Some original animal test result documents and other material she refers to can be found on this website.

Case Report of Myodil Induced Adhesive Arachnoiditis 2006
A case report by Kanna K. Gnanalingham published in the European Spine Journal, describing a woman who underwent a Myodil Myelogram 30 years previously who presents symptoms of Adhesive Arachnoiditis and an Arachnoid cyst. The case report concludes that Myodil was the sole cause of her symptoms because she hadn't undergone any other treatments or investigations.

2006 Dr. Aldrete Suspecting & Diagnosing Arachnoiditis

Three Short Articles Written By Dr. Burton on the subjects of Pantopaque (Myodil), Adhesive Arachnoiditis, and Governmental Responsibility

December 2010: An article by Gopalakrishnan CV, Mishra A, Thomas B. published in the British Journal of Neurosurgery describing a case of Iophendylate myelography induced thoracic arachnoiditis, arachnoid cyst and syrinx, four decades later. (Link to report)

Dr. Burton's November 2011 letter
Letter written to Ursula Coxhead in which Dr. Burton states in all cases Myodil caused toxic chemical meningitis, and then progressed leading to the secondary condition diffuse Adhesive Arachnoiditis.

September 2012, Good friend Dr. Charles V. Burton M.D. F.A.C.S sent Ursula Coxhead an article, "Mengele in America: Human Experimentation and the Walter Reed Connection," which he wrote for the Journal: Ethics in Biology; Engineering and Medicine.

September 2012: Australian Parliamentary round table inquiry attended by health care professionals and Myodil sufferers. Three doctors all gave testimony stating Myodil is responsible for the onset of Adhesive Arachnoiditis. (Link to minutes)

February 2013: Australian Parliamentary round table inquiry committee publishes report stating amongst other things that Glaxo should consider setting up a charitable foundation to the assist the Australian sufferers of Myodil induced Adhesive Arachnoiditis. (Link to report)

February 2013: An articel by Ririko Takeda, MD and Hiroki Kurita, MD, PhD publisehd in the journal Neurology. Residual contrast media found around a patients brain 49 years after Myelography. In September 2011, a 67-year-old man underwent 3-dimensional CT angiography for preoperative evaluation of an unruptured cerebral aneurysm, which revealed numerous pearl-like drops along the cerebral arteries (figure 1). He had undergone myelography for lumbar disc herniation in 1962, and the drops were thought to represent remnant oily contrast medium that had been in place for 49 years. At surgery, several oily drops and yellowish gelatinous substance were identified and partially removed (figure 2). Histopathologically, the drops were compatible with artificial material. (Link to report)

May 2013: An article by Sang-Kook Lee, Daniel H. Kim, Se-Hoon Kim, Dong-Jun Lim published in the European Spine Journal. A case study of a 63 year old woman who presented with symptoms of incresaing back pain and lower limb paresthesia and incontinence. An x-ray was taken which showed a large drop of Pantopaque present in the thoracic level of the spinal cord. (Link to journal)