Kim KO, Lee T, Kim T. Non-convulsive status epilepticus in the immediate postoperative period following spine surgery.
Korean J Anesthesiol 2021;
74:541-545. [PMID:
33401346 PMCID:
PMC8648515 DOI:
10.4097/kja.20527]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 01/01/2021] [Indexed: 11/10/2022] Open
Abstract
Background
Non-convulsive status epilepticus (NCSE), in which continuous epileptiform discharges occur without seizure-like movement, is rare and unfamiliar to anesthesiologists, both of which make this condition overlooked in patients with decreased levels of consciousness following general anesthesia.
Case
We report on an elderly female patient who developed NCSE in the immediate postoperative period after the spine surgery. Initially, delayed emergence from anesthesia was suspected, but the electroencephalogram confirmed NCSE, and anticonvulsant therapy was initiated.
Conclusions
Delayed emergence is commonly attributed to cerebrovascular events or residual anesthetic effects, but NCSE must be included in the differential diagnosis, especially in elderly patients. Anticonvulsant therapy should be initiated as soon as possible for a better prognosis.
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