Department of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang, Korea.
Korean J Anesthesiol. 2021 Dec;74(6):541-545. doi: 10.4097/kja.20527. Epub 2021 Jan 5.
Non-convulsive status epilepticus (NCSE), in which continuous epileptiform discharges occur without seizure-like movement, is rare and unfamiliar to anesthesiologists, both of which make this condition overlooked in patients with decreased levels of consciousness following general anesthesia.
We report on an elderly female patient who developed NCSE in the immediate postoperative period after the spine surgery. Initially, delayed emergence from anesthesia was suspected, but the electroencephalogram confirmed NCSE, and anticonvulsant therapy was initiated.
Delayed emergence is commonly attributed to cerebrovascular events or residual anesthetic effects, but NCSE must be included in the differential diagnosis, especially in elderly patients. Anticonvulsant therapy should be initiated as soon as possible for a better prognosis.
非惊厥性癫痫持续状态(NCSE),即持续出现癫痫样放电而无癫痫样运动,在麻醉医生中较为罕见且不熟悉,这使得在全麻后意识水平下降的患者中容易忽视这种情况。
我们报告了一例老年女性患者,在脊柱手术后的即刻术后期间发生 NCSE。最初,怀疑是麻醉苏醒延迟,但脑电图证实了 NCSE,并开始了抗癫痫治疗。
麻醉苏醒延迟通常归因于脑血管事件或残留麻醉作用,但 NCSE 必须包括在鉴别诊断中,尤其是在老年患者中。为了获得更好的预后,应尽快开始抗癫痫治疗。