This Article Résumé de cet Article Full Text Full Text (PDF) Submit a scholarly reply Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Mohanram, A. Articles by Pagel, P. S. Search for Related Content PubMed PubMed Citation Articles by Mohanram, A. Articles by Pagel, P. S.

Repetitive generalized seizure-like activity during emergence from sevoflurane anesthesia

[Activité semblable à une crise convulsive répétitive généralisée pendant l’émergence de l’anesthésie au sévoflurane]

From the Anesthesia Service, Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, Wisconsin, USA.

Address correspondence to: Dr. Paul S. Pagel, Clement J. Zablocki Veterans Affairs Medical Center, Anesthesia Service, 5000 W. National Avenue, Milwaukee, Wisconsin, USA 53295. Phone: 414-384-2000, ext. 42417; Fax: 414-384-2939; E-mail: pspagel{at}mcw.edu

Purpose: Sevoflurane-induced seizures are most often described during mask induction of anesthesia when high concentrations of the volatile agent are administered concomitant with alveolar hyperventilation. The occurrence of seizure-like activity during emergence from sevoflurane anesthesia has been rarely reported.

Clinical features: We describe a patient who developed several episodes of generalized tonic-clonic seizure-like activity during and immediately after emergence from sevoflurane anesthesia and discuss the potential factors that contributed to this unusual complication. The patient was treated with intravenous propofol, midazolam, and phenytoin and required intensive care management before his neurologic status stabilized.

Conclusion: The report emphasizes that sevoflurane is capable of producing excitatory central nervous system (CNS) phenomena in spite of causing primarily CNS depressant effects.