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Intraoperative Seizure Under General Anesthesia Not Detected by EEG: A Case Report
Sumanya Kumar1, Alexander J Rodriguez2, Mark A Burbridge2
1Anesthesiology, University of Connecticut School of Medicine, Farmington, USA.
Cureus
|September 4, 2023
Summary
Intraoperative seizures under general anesthesia can be missed by electroencephalography (EEG) due to electrode placement issues. Prompt seizure treatment is crucial even if EEG confirmation is delayed.
Area of Science:
- Neurology
- Anesthesiology
- Neurosurgery
Background:
- Intraoperative seizures during general anesthesia are rare but possible.
- Continuous electroencephalography (EEG) monitoring is standard for detecting seizure activity.
Observation:
- A patient undergoing brain tumor resection experienced motor seizure manifestations.
- EEG monitoring failed to detect the seizure due to suboptimal electrode placement over a skull defect.
Findings:
- Postoperative EEG confirmed seizure activity, indicating a missed intraoperative event.
- Limitations in EEG lead placement, particularly after hemicraniectomy, can lead to false negatives.
Implications:
- Anesthesiologists must recognize that EEG may not always detect intraoperative seizures.
- Prompt treatment for suspected intraoperative seizures is essential, regardless of immediate EEG confirmation.
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01:13Seizures: Classification
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Epilepsy is primarily characterized by unpredictable seizures, either provoked by an identifiable factor, such as injury or illness, or unprovoked, occurring spontaneously without apparent cause.
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types:
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01:24General Anesthesia: Overview
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General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
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