title: Report of seizure following intraoperative monitoring of transcranial motor evoked potentials.
abstract: BACKGROUND
  Transcranial motor evoked potentials are used to detect iatrogenic injury to the corticospinal tracts and vascular territory of the anterior spinal artery. Tongue and lip lacerations are the most common complication of this modality. Theoretical complications include cardiac arrhythmia and seizure although there are no published reports of either.
  
  
  METHODS
  We report a case of postoperative seizure following motor evoked potential testing in a patient without a seizure history. Although anecdotal reports exist, ours is the first known published report of seizure following transcranial electrical stimulation.
  
  
  CONCLUSIONS
  The intent of this novel report is to encourage the use of anesthetic regimens that raise seizure threshold, decrease stimulation threshold, and increase the specificity of motor evoked potentials. Providers should be prepared to treat intraoperative or perioperative seizure activity when the monitoring protocol includes transcranial motor evoked potentials.
authors.affiliation: Department of Anesthesiology, Tulane University and Louisiana State University Schools of Medicine, New Orleans, LA ; PhysIOM, Ft. Collins, CO.
authors.forename: Scott F
authors.initials: SF
authors.lastname: Davis
authors.affiliation: Southern Oregon Neurological and Spine Associates, Medford, OR.
authors.forename: Thomas
authors.initials: T
authors.lastname: Altstadt
authors.affiliation: PhysIOM, Ft. Collins, CO.
authors.forename: Rick
authors.initials: R
authors.lastname: Flores
authors.affiliation: Department of Anesthesiology, Louisiana State University School of Medicine, New Orleans, LA.
authors.forename: Alan
authors.initials: A
authors.lastname: Kaye
authors.affiliation: PhysIOM, Ft. Collins, CO.
authors.forename: Glenn
authors.initials: G
authors.lastname: Oremus
keywords: Anesthesia; complications; evoked potentials—motor; monitoring—intraoperative; seizures