In general, when seizures occur during surgery, their onset often coincides with the introduction of a specific anesthetic or analgesic drug. However, there have been reports of postoperative convulsions that appeared to be caused by anesthetic or analgesic drugs administered intraoperatively via injection or inhalation.

Some anesthetics may possess proconvulsant properties, anticonvulsant properties, or both. One possible factor is an inherent pharmacodynamic variability in the responsiveness of inhibitory and excitatory target tissues in the central nervous system.23

The effects of general and local anesthetics on seizure threshold have been examined to determine intrinsic pharmacologic properties and mechanisms of action; interictal and ictal effects on surface, depth, or cortical electroencephalogram (EEG) recordings; and behavioral effects in animals and humans.

The following pages discuss specific types of anesthetics:

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
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Reviewed By: 
Steven C. Schachter MD
on: 
Thursday, April 1, 2004