Etomidate is a hypnotic nonbarbiturate, ultra–short-acting anesthetic agent associated with involuntary muscle movements in 10–70% of patients. These movements can be violent and mimic seizure activity. Etomidate is often administered because of its cardiovascular stabilizing effect. In patients without epilepsy, surface electrode recordings during the myoclonic movements are not associated with epileptiform activity.54

In epilepsy patients, etomidate (0.2 mg/kg) can activate seizure foci within 30 seconds55 and has been used intraoperatively for this purpose.

Despite the lack of evidence that etomidate causes seizures in nonepileptic patients, epileptiform activity occurred in 6 of 30 nonepileptic patients who were induced with etomidate for heart valve replacement.54

Adapted from: Najjar S, Devinsky O, Rosenberg AD, et al. Procedures in epilepsy patients. In: Ettinger AB and Devinsky O, eds. Managing epilepsy and co-existing disorders. Boston: Butterworth-Heinemann; 2002;499–513. With permission from Elsevier (www.elsevier.com).

Authored By: 
Orrin Devinsky MD
Souhel Najjar MD
Andrew D Rosenberg MD
I<
Reviewed By: 
Steven C. Schachter MD
on: 
Wednesday, March 31, 2004