CC BY-NC-ND 4.0 · J Neuroanaesth Crit Care 2017; 04(04): S114
DOI: 10.1055/s-0038-1646260
Abstracts
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Acute hypotension as a manifestation of seizures intraoperatively

P. Unnikrishnan
1   Department of Anesthesiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
,
S. Vimala
1   Department of Anesthesiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
,
N. S. Gautham
1   Department of Anesthesiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
› Author Affiliations
Further Information

Publication History

Publication Date:
09 May 2018 (online)

Introduction: The most common hemodynamic change observed during seizures is sympathetic activation. But dysautonomia associated with seizures leading to hypotension is also a probability in such situations. Case Summary: We report an unusual manifestation of seizures as significant hypotension in a young lady who underwent a transcranial decompression of pituitary macroadenoma. The first episode occurred during the intraoperative period (fall in systolic blood pressure (BP) from 110 to 30 mm Hg) but the clinical manifestations were masked because of general anesthesia and muscle relaxation. On the second occasion, a GTCS occurred in the intensive care unit with concomitant hypotension (systolic BP falling to 40 mm Hg). Both episodes required vasopressor support to restore BP to normal levels. Conclusion: Acute hypotension unexplainable by other causes can be a manifestation of seizure during anesthesia for neurosurgery. Hypotension caused by dysautonomia can produce cerebral hypoperfusion and prolong EEG suppression leading to a vicious cycle. So rapid identification of seizure as a cause for hypotension and its prompt control, can avoid further cerebral ischemia during neurosurgeries.