No abstract

Dr_mlNa Tm~ LAST TWO Y~ARS continuous electroencephalograms have been taken during surgmal cases m an effort to correlate the changes in the brain wave patterns with the depth of anaesthesia We have had the opporttmlty to study a variety of anaesthetm agents, and to observe the more or less gradual development of various critical conditions in a number of ,our cases One of these we have reported (1), but the present ease is bastcally different and o~ sufficient general interest to warrant a detailed descnpt_ton As will be explained in the body of tl~s report, we were able to watch the development of a locahzed ,epfleptac dlscharge m a patmnt with a pre-exastmg neurological lesmn. Apparently the anaesthetic techmque and/or the operative procedure aggravated the focal disorder and precipitated the cerebral symptoms A retropubic prostatectomy was performed on a poor i lsk pataent with a lalstory of an old cerebrovascular accident The electroencephalogram was used for purposes of study and as a control to keep the pataent at an analgesm level it has been our experience that the electroencephalogram is an excellent tool winch aids the anaesthesmloglst m mamtamlng a patient at the desired level of analgesia or surgical anaesthesm It was during tins surgical procedure that the electroencephalogram recorded a right cortmal seizure fully two minutes before ,t left-sided Jacksoman seizure was noted chmeally PATIENT'S HISTORYA 67-year-old white male was admitted April 12, ]958 with a diagnosis of acute urinary retention Physical examination revealed blood pressure of 180/75 and a regular -gulse There was a left lower facial paresis, and some deviation of the head to the _-eft Pupils were equal and reacted to light and aceommodat~Lon Extra-ocular movements were normal Control of fine movements was absent m the left hand and there was residual weakness of the left side of his body The remainder of the neurologmal examination gave normal findmT, s for the patmnt's age Prostate was found to be 2 to 8 plus enlarged and nodular k~he electroeardlograpme tracing revealed coronary msufl~cmncy and ventncular strata Serology was negatwe wa~ blood count and urinalysis reported within normal hmlts The -~atmnt had a history of hyoertensmn and cerebrovascular accident in 1947 at whm a t~me there was a h~rpoaestnesm of the left side of the face Corneal reflexes were apparent on the left "~Vhen the pataent's law was opened, there was a deviation to the right There was left faeml droop and the tongue devmted left with some tremor The shoulder muscles were weak on the left. Hypoaesthesm existed on the left and the deep tendon reflexes were absent that side 1Dwlslon