Anesthesia-related status epilepticus after fiber optic colonoscopy in a child

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Abstract

A healthy, 8-year-old girl with a history of hematochezia underwent an uneventful fiber optic colonoscopy with propofol anesthesia. During the postoperative recovery period, she experienced acute-onset muscle rigidity, loss of consciousness, apnea, hypoxia, and hyperthermia. She was administered cardiopulmonary resuscitation and was treated with naloxone, mannitol, and midazolam. She regained consciousness after 14 hours. She underwent cerebral function rehabilitation and was discharged in 1 month without obvious neurologic sequelae. This case illustrates that propofol may affect the developing brain differently from the adult brain. Propofol-induced seizures can lead to life-threatening status epilepticus in children. Immediate diagnosis and effective treatment are essential.

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Most cited references 14

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Effect of propofol on seizure-like phenomena and electroencephalographic activity in children with epilepsy vs children with learning difficulties.

J-U Grundmann, Antje S. Meyer, S Gottschling … (2006)

There is an ongoing debate as to whether propofol exhibits pro- or anticonvulsant effects, and whether it should be used in patients with epilepsy. We prospectively assessed the occurrence of seizure-like phenomena and the effects of intravenous propofol on the electroencephalogram (EEG) in 25 children with epilepsy (mean (SD) age: 101 (49) months) and 25 children with learning difficulties (mean (SD) age: 52 (40) months) undergoing elective sedation for MRI studies of the brain. No child demonstrated seizure-like phenomena of epileptic origin during and after propofol sedation. Immediately after stopping propofol, characteristic EEG changes in the epilepsy group consisted of increased beta wave activity (23/25 children), and suppression of pre-existing theta rhythms (11/16 children). In addition, 16 of 18 children with epilepsy and documented EEG seizure activity demonstrated suppression of spike-wave patterns after propofol sedation. In all 25 children with learning difficulties an increase in beta wave activity was seen. Suppression of theta rhythms occurred in 11 of 12 children at the end of the MRI study. In no child of either group was a primary occurrence or an increase in spike-wave patterns seen following propofol administration. The occurrence of beta wave activity (children with learning difficulties and epilepsy group) and suppression of spike-wave patterns (epilepsy group) were transient, and disappeared after 4 h. This study demonstrates characteristic, time-dependent EEG patterns induced by propofol in children with epilepsy and learning difficulties. Our data support the concept of propofol being a sedative-hypnotic agent with anticonvulsant properties as shown by depression of spike-wave patterns in children with epilepsy and by the absence of seizure-like phenomena of epileptic origin.

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Propofol treatment in adult refractory status epilepticus. Mortality risk and outcome.

Kjersti Nesheim Power, Hans Flaatten, Nils Gilhus … (2011)

To retrospectively study effect and safety of propofol treatment in adult refractory generalised tonic clonic status epilepticus.

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The effect of propofol-remifentanil anesthesia on selected seizure quality indices in electroconvulsive therapy

Morris Goldman, David B Glick, Stephen H Dinwiddie (2012)

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Affiliations

[1 ]Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Department of Anesthesiology, Children's Hospital, Chongqing Medical University, Chongqing, China.

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[* ]Corresponding author's e-mail address: shushiyu@ 123456hotmail.com

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Shiyu Shu: (View ORCID Profile)

Journal

Journal ID (publisher-id): SOR-MED

Title: ScienceOpen Research

Publisher: ScienceOpen

ISSN (Electronic): 2199-1006

Publication date 06 July 2015

Volume: 0 (ID: 81998c00-a965-403a-b096-a9dc969dcff1 )

Issue: 0

Pages: 1-6

Publisher ID: 2876:XE

DOI: 10.14293/S2199-1006.1.SOR-MED.AXK5RB.v1

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This work has been published open access under Creative Commons Attribution License CC BY 4.0 , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Conditions, terms of use and publishing policy can be found at www.scienceopen.com .

Anesthesia-related status epilepticus after fiber optic colonoscopy in a child

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Most cited references 14

Effect of propofol on seizure-like phenomena and electroencephalographic activity in children with epilepsy vs children with learning difficulties.

Propofol treatment in adult refractory status epilepticus. Mortality risk and outcome.

The effect of propofol-remifentanil anesthesia on selected seizure quality indices in electroconvulsive therapy

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ScienceOpen disciplines:	Medicine, Anesthesiology & Pain management
Keywords:	remifentanil, propofol, seizure-like phenomenon, pediatric anesthesia