Intrapartum seizure in a patient undergoing cesarean delivery: differential diagnosis and causative factors

This case describes the unusual occurrence of grand mal seizures in a 28-year-old patient undergoing a repeat cesarean delivery during spinal anesthesia. The patient had an absence of preeclampsia. Medical history included a closed head injury with seizures at the time of injury and for a brief time thereafter, with no further seizures in the subsequent 9 years. The patient was treated with fosphenytoin and benzodiazepines. She underwent a postoperative neurologic workup, which included computed tomography, bloodwork, and electroencephalography, and all results were normal. It was determined that the seizure was the result of brain scarring from the previous head injury. A review of the current literature regarding seizures in the parturient and causative factors for this patient are discussed.