Report of seizure following intraoperative monitoring of transcranial motor evoked potentials

• Published in: The Ochsner journal Vol. 13; no. 4; pp. 558 - 560
• Main Authors: Davis, Scott F, Altstadt, Thomas, Flores, Rick, Kaye, Alan, Oremus, Glenn
• Format: Report
• Language: English
• Published: 01.01.2013
• ISSN: 1524-5012

BACKGROUNDTranscranial 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 REPORTWe 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. CONCLUSIONThe 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.