24 Questions
What is a major concern related to seizure activity during anesthesia?
Potential for neuronal injury due to lack of recognition
Why should the use of enflurane be avoided in patients predisposed to seizures?
potentially epileptogenic
What is one way enflurane has been used intraoperatively in neuroanesthesia?
To activate and identify seizure foci
How does hypocapnia affect seizure-type discharges during enflurane anesthesia?
It potentiates the discharges
Why is enflurane use with hypocapnia advised against in patients predisposed to seizures?
It can elevate CMR and induce seizures
What is one benefit of enflurane's EEG-activating property during surgery?
To locate and identify seizure foci for resection
Which inhalational anesthetic has been successfully used to control EEG seizure activity in refractory status epilepticus?
Isoflurane
In which scenario has the use of sevoflurane shown the ability to evoke epileptiform activity?
In patients without a recognized seizure diathesis
Why should the use of sevoflurane in patients with epilepsy be approached with caution?
It has a small but potential to evoke epileptiform activity
Which inhalational anesthetic has a noted association with seizures during high concentrations in children, even those without a recognized seizure diathesis?
Sevoflurane
What is a potential risk associated with administering larger doses of Methohexital to produce burst suppression of the EEG?
Refractory seizures
What is the primary purpose of using Methohexital during cortical mapping?
Inducing seizure foci
What distinguishes the seizure activity related to Methohexital administration in neurosurgical patients from that seen in ECT patients?
Prolonged seizure activity
How has ketamine been utilized in the context of status epilepticus?
For controlling seizure episodes
What conclusion can be drawn about the significance of ketamine-induced seizure activity?
Not a significant concern
In what scenario does the use of ketamine pose a risk to patients?
Patients with an epileptic diathesis
What effect on EEG activity has been observed with the use of etomidate in epileptic patients?
It induces generalized epileptic EEG activity
In comparison to methohexital and propofol, what is a characteristic of seizures induced by etomidate during ECT?
longer seizures
Which anesthetic is NOT recommended for patients with a history of epilepsy due to its potential impact on seizure activity?
Etomidate
What distinguishes the myoclonus caused by etomidate from the seizures induced by methohexital and propofol?
Presence of epileptiform activity on EEG
What effect has been observed on ECT seizures when comparing propofol to methohexital?
Propofol shortens ECT seizures
What role has propofol been suggested to play in terms of being a proconvulsant?
Propofol is unlikely to exhibit proconvulsant properties
What EEG activity has been observed alongside the use of propofol despite no reported seizures?
Pronounced high-amplitude beta-frequency activity
What is a distinguishing factor between methohexital and propofol in relation to ECT seizures?
Propofol induces shorter ECT seizures
Explore the concerns regarding epileptogenic potential of commonly used anesthetics, the risks of unrecognized seizure activity in an anesthetized patient, and the persistence of epileptogenic effects in the post-anesthesia period.
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