We have located links that may give you full text access.
Case Reports
Journal Article
Seizures after percutaneous endoscopic lumbar discectomy: A case report.
Medicine (Baltimore) 2020 November 21
RATIONALE: Percutaneous endoscopic lumbar discectomy (PELD) is a minimally invasive technique for removing nucleus pulposus and achieving neural decompression via a posterolateral approach. PELD is known to have a very low rate of complications during the perioperative period. Although quite rare, seizures can occur in patients undergoing PELD.
PATIENT CONCERNS: A 58-year-old man with severe low back pain underwent the PELD procedure under general anesthesia. During the recovery phase after general anesthesia, the patient developed a tonic-clonic seizure. Two additional episodes occurred subsequently.
DIAGNOSES: Bilateral disc swelling indirectly supports the diagnosis of intracranial hypertension.
INTERVENTIONS: Midazolam and propofol were administered to control seizures. 1.0 g phenobarbital sodium was administered by intravenous injection. Ten milligrams of furosemide and 250 mL of mannitol (20%) were prescribed sequentially. Two hundred milligrams of hydrocortisone and an ice bag were used to protect the brain. Urapidil, metoprolol, and nicardipine were intermittently used to control his blood pressure. A sustained release of sodium valproate was administered and continued prophylactically for 4 weeks.
OUTCOMES: No further seizures were recorded and the patient recovered well.
LESSONS: We conclude that total volume of fluid used for irrigation was considered a possible cause of seizure. This case illustrates the fact that irrigation should be performed cautiously in PELD procedure. And anesthesiologists should be familiar with the management strategies of perioperative acute seizures.
PATIENT CONCERNS: A 58-year-old man with severe low back pain underwent the PELD procedure under general anesthesia. During the recovery phase after general anesthesia, the patient developed a tonic-clonic seizure. Two additional episodes occurred subsequently.
DIAGNOSES: Bilateral disc swelling indirectly supports the diagnosis of intracranial hypertension.
INTERVENTIONS: Midazolam and propofol were administered to control seizures. 1.0 g phenobarbital sodium was administered by intravenous injection. Ten milligrams of furosemide and 250 mL of mannitol (20%) were prescribed sequentially. Two hundred milligrams of hydrocortisone and an ice bag were used to protect the brain. Urapidil, metoprolol, and nicardipine were intermittently used to control his blood pressure. A sustained release of sodium valproate was administered and continued prophylactically for 4 weeks.
OUTCOMES: No further seizures were recorded and the patient recovered well.
LESSONS: We conclude that total volume of fluid used for irrigation was considered a possible cause of seizure. This case illustrates the fact that irrigation should be performed cautiously in PELD procedure. And anesthesiologists should be familiar with the management strategies of perioperative acute seizures.
Full text links
Related Resources
Trending Papers
Consensus Statement on Vitamin D Status Assessment and Supplementation: Whys, Whens, and Hows.Endocrine Reviews 2024 April 28
The Tricuspid Valve: A Review of Pathology, Imaging, and Current Treatment Options: A Scientific Statement From the American Heart Association.Circulation 2024 April 26
British Society of Gastroenterology guidelines for the management of hepatocellular carcinoma in adults.Gut 2024 April 17
Interstitial Lung Disease: A Review.JAMA 2024 April 23
Ventilator Waveforms May Give Clues to Expiratory Muscle Activity.American Journal of Respiratory and Critical Care Medicine 2024 April 25
Systemic lupus erythematosus.Lancet 2024 April 18
Acute Kidney Injury and Electrolyte Imbalances Caused by Dapagliflozin Short-Term Use.Pharmaceuticals 2024 March 27
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app