New onset epilepsy following unintentional durotomy in a patient on anti-psychiatric medication

Abstract

We would like to present a rare case report describing a case in which new-onset tonic-clonic seizures occurred following an unintentional durotomy during lumbar discectomy and decompression. Unintentional durotomy is a frequent complication of spinal surgical procedures, with a rate as high as 17%. To our knowledge a case of new onset epilepsy has never been reported in the literature. Although dural tears during surgery and CSF hypovolaemia are thought to be the main contributing factors, one postulates on the effects of anti-psychiatric medication with epileptogenic properties. Amisulpride and Olanzapine can lower seizure threshold and should be used with caution in patients previously diagnosed with epilepsy. However manufacturers do not state that in cases where the seizure threshold is already lowered by CSF hypotension, new onset epilepsy might be commoner. Finally, strong caution and aggressive post-operative monitoring is advised for patients with CSF hypotension in combination with possible epileptogenic medication.

Compatibility of a Novel Thrombospondin-1 Analog with Fertility and Pregnancy in a Xenograft Mouse Model of Endometriosis

“…Common ectopic locations include the ovaries, fallopian tubes, and pelvic peritoneum [ 1 ]. Endometriotic lesions can result in the physical blockage of the fallopian tubes and can impair ovarian function contributing to up to 50% of cases of female infertility [ 1 , 6 – 9 ]. Approximately 176 million women of reproductive age are affected by endometriosis, many of which are suffering with subfertility or infertility [ 1 , 6 – 8 ].…”

“…Endometriotic lesions can result in the physical blockage of the fallopian tubes and can impair ovarian function contributing to up to 50% of cases of female infertility [ 1 , 6 – 9 ]. Approximately 176 million women of reproductive age are affected by endometriosis, many of which are suffering with subfertility or infertility [ 1 , 6 – 8 ]. In the United States and Canada alone, $23.8 billion dollars ($22 billion USD, $1.8 billion CAD) are spent annually on the diagnosis and treatment of endometriosis [ 2 – 4 ].…”