Postoperative seizure‐like activity following sevoflurane anesthesia

Abstract

Generalized clonic and tonic seizure-like movements were observed during emergence from anesthesia with sevoflurane in a 32-year-old man. The movements lasted 40 sec and necessitated no therapy. There were no significant effects of the incident on the cardiovascular system, such as hypotension, arrhythmia or bradycardia. No neurological abnormalities were obvious after the anesthesia. The movements may have been the result of seizure activity in the central nervous system, or myoclonus of the whole body.

Prolonged myoclonus after a single bolus dose of propofol

“…Propofol has been the most often and controversially discussed drug in this context during the past few years [2]. Fentanyl [19,20] and sevoflurane [21] may cause neurological complications but as far as we are aware, association with opisthotonus and myoclonus has not been described. In contrast, propofol has frequently been reported to cause this movement disorder [1,2,4,[6][7][8].…”

Convulsions on anaesthetic induction with sevoflurane in young children

“…S INCE commercial release of sevoflurane on the global market in 1990, there have been several clinical reports of tonic and clonic seizure-like movements in patients undergoing sevoflurane anaesthesia (1)(2)(3)(4). Some authors (3-13) have even suggested a correlation between the exposure to sevoflurane and electrocortical seizure activity.…”

Prolonged Seizure like Activity after Sevoflurane Based Anesthesia

“…Although it is well tolerated by majority of patients, there are reports of serious adverse effects such as coughing, laryngospasm, desatuaration, sympathetic stimulation causing tachycardia and hypertension and emerge delirium and agitation associated with use of high concentration of sevoflurane. Sevoflurane has been reported to be associated with transient seizure like electrical activity or myoclonic movements that are often self limiting [3][4][5][6]. Although the agitation associated with sevoflurane anesthesia is not linked to seizure as evidence by absence of typical epileptiform activity in EEG [7]; however, its use is controversial in neurosurgery or in patients with epilepsy [8].…”

“…Although Sevoflurane is well tolerated in majority of patients, occasional adverse effects have been reported like coughing, laryngospasm, tachycardia, hypertension, emergence delirium and agitation [2]. Very transient self limiting seizure like activities has been reported with sevoflurane anaesthesia [3]. We encountered prolonged seizure like activities in a 5 years old child in the postoperative period following Sevoflurane based anaesthesia for tonsillectomy, necessitating use of antiepileptic mediation to control the seizure and postoperative intensive care monitoring.…”