Table 1 Key findings in past reports of super-refractory status epilepticus attributable to spinal anesthesia
Year and Country | Drugs administered | Clinical features | Investigations | Medical History |
|---|---|---|---|---|
2014 Turkey [1] | Heavy bupivacaine 12.5 mg (Marcaine) | Perineal pain, myclonus of leg followed by status epilepticus | The contrast MRI-Brain, MRI venography and arteriography were normal. EEG showed a slow wave activity originating from the bilateral frontal areas. CSF analysis was normal. CK was > 4000U/l. | Nothing |
2020 India [2] | heavy bupivacaine 11Â mg | LSCS-After delivery of the baby mother had headache and neck rigidity followed by status epilepticus | MRI brain:leptomeningitis with associated evolving cerebritis. CSF analysis was normal | Nothing |
2022 Belgium [3] | heavy bupivacaine 15 mg with 0.25 µg sufentanil | myoclonus leading to status epilepticus | CT and MRI of the brain were normal. CSF analysis was normal. EEG:epileptic activity | hysterectomy and supraventricular tachycardia |
2022 Portugal [4] | heavy bupivacaine 11.25 mg and 3.75 µg sufentanil | Tremor > converted to general anesthesia > status epilepticus. Also had cardiac effects including ventricular fibrillation | CT and MRI of the brain: hypoxic-ischemic brain injury | osteoarthritis |
2022 India [5] | heavy bupivacaine 10 mg | Perineal discomfort > up rolling of eyes > rigidity > GTCS > anterograde amnesia | CSF analysis was normal. MRI: lesions suggestive of vasogenic edema with a distribution typical of posterior reversible encephalopathy syndrome. EEG(day 11) normal | preeclampsia and (on labetalol) |
2022 India [6] | heavy bupivacaine 11 mg | itching in the coccyx region with flushing of face > restless > GTCS | Not mentioned | Nothing |