Focal status epilepticus induced by hyperbaric oxygen therapy.

INTRODUCTION: generalized tonic clonic (GTC) seizure activity because of central nerve system oxygen toxicity is a rare but recognized effect of HBOT (hyperbaric oxygen therapy). Almost all case reports and database analyses about the relationship between seizure activity and HBOT point out that GTC seizures and status epilepticus are more likely to occur as a result of the treatment and there are only few reports demonstrating partial seizures.

CASE REPORT: an 87-year-old male patient was admitted to our clinic because of tonic-clonic contractions on his left arm. He was under HBOT because of a decubitis ulcer. After repeated exposures to hyperbaric oxygen, he had contractions on his left arm. He was diagnosed as focal motor status. There was no evidence of acute ischemia or mass lesion on brain magnetic resonance imaging. IV phenytoin (diphenylhydantoin) 20 mg/kg was given over 30 minutes and continued orally with phenytoin at a dose of 300 mg/d. He had no subsequent seizures.

CONCLUSION: GTC seizures or status epilepticus as a result of GTC seizures are more common than focal seizures as neurologic complications of HBOT. Partial seizures as a neurologic complication of HBOT have rarely been reported and to our knowledge, this is the first case which is characterized by focal status epilepticus induced by HBOT.