经颅运动诱发电位术中监测后癫痫发作报告。
Report of seizure following intraoperative monitoring of transcranial motor evoked potentials.
作者信息
Davis Scott F, Altstadt Thomas, Flores Rick, Kaye Alan, Oremus Glenn
机构信息
Department of Anesthesiology, Tulane University and Louisiana State University Schools of Medicine, New Orleans, LA ; PhysIOM, Ft. Collins, CO.
Southern Oregon Neurological and Spine Associates, Medford, OR.
出版信息
Ochsner J. 2013 Winter;13(4):558-60.
BACKGROUND
Transcranial motor evoked potentials are used to detect iatrogenic injury to the corticospinal tracts and vascular territory of the anterior spinal artery. Tongue and lip lacerations are the most common complication of this modality. Theoretical complications include cardiac arrhythmia and seizure although there are no published reports of either.
CASE REPORT
We report a case of postoperative seizure following motor evoked potential testing in a patient without a seizure history. Although anecdotal reports exist, ours is the first known published report of seizure following transcranial electrical stimulation.
CONCLUSION
The intent of this novel report is to encourage the use of anesthetic regimens that raise seizure threshold, decrease stimulation threshold, and increase the specificity of motor evoked potentials. Providers should be prepared to treat intraoperative or perioperative seizure activity when the monitoring protocol includes transcranial motor evoked potentials.
背景
经颅运动诱发电位用于检测对皮质脊髓束和脊髓前动脉血管区域的医源性损伤。舌部和唇部撕裂伤是这种检查方式最常见的并发症。理论上的并发症包括心律失常和癫痫发作，不过尚无关于这两种情况的公开报道。
病例报告
我们报告一例在无癫痫病史的患者中进行运动诱发电位测试后出现术后癫痫发作的病例。尽管有一些传闻报道，但我们的病例是经颅电刺激后癫痫发作的首例已知公开报道。
结论
这份新报告的目的是鼓励采用提高癫痫阈值、降低刺激阈值并增加运动诱发电位特异性的麻醉方案。当监测方案包括经颅运动诱发电位时，医护人员应准备好处理术中或围手术期的癫痫发作活动。
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