Convulsions after enflurane in a schizophrenic patient receiving neuroleptics

A schizophrenic patient suffered from an episode of unexpected grand mal seizure following an enflurane unaesthetic for biopsy of an orbital lesion. The seizure was brief and subsided spontaneously. An assessment of the anaesthetic technique and a thorough neurological examination which included a CT scan and an EEG, failed to demonstrate any obvious cause for the convulsion. The patient was not an epileptic and was receiving neuroleptic drugs preoperatively for the treatment of schizophrenia. A synergistic role of enflurane and neuroleptic drugs is producing seizure activity in this patients is a distinct possibility. Caution is therefore recommended when administering enflurane to patients on neuroleptic drugs.