title: Intraoperative seizure and cerebrospinal fluid leak during adult cochlear implant surgery.
abstract: OBJECTIVE
  To report a rare case of cerebrospinal fluid gusher and subsequent seizure immediately after cochlear implant electrode insertion.
  
  
  METHODS
  After the cochlear implant electrode was inserted, brisk flow of 10 mL of cerebrospinal fluid was seen. The electrode was promptly inserted and the leak was additionally sealed with fascia. Seconds later, the patient had a tonic-clonic seizure lasting 30 seconds. Two additional episodes occurred during the case. Her postoperative course was uneventful with no subsequent seizures. The device has been successfully activated. Intervention & Technique: Postoperative imaging showed correct intracochlear placement of the electrode as well as an incidental enlarged vestibular aqueduct. Neurology consultation including electroencephalogram was unremarkable.
  
  
  CONCLUSIONS
  To our knowledge, this is the first report of a seizure temporally associated with cochlear implant electrode insertion. The significance and possible casual relationship between these two events is discussed.
authors: a Departments of Surgery, Division of Oral and Maxillofacial Surgery , University of Cincinnati College of Medicine , Cincinnati , OH , USA.
authors: Alexander B
authors: AB
authors: Musser
authors: b Otolaryngology-Head and Neck Surgery, University of Cincinnati Medical Center , CIncinnati , OH , USA.|d Neurosensory Disorders Center, University of Cincinnati Neuroscience Institute , Cincinnati , OH , USA.|e Department of Otolaryngology-Head and Neck Surgery , Columbia University College of Physicians and Surgeons , New York , NY , USA.
authors: Justin S
authors: JS
authors: Golub
authors: b Otolaryngology-Head and Neck Surgery, University of Cincinnati Medical Center , CIncinnati , OH , USA.|d Neurosensory Disorders Center, University of Cincinnati Neuroscience Institute , Cincinnati , OH , USA.
authors: Ravi N
authors: RN
authors: Samy
authors: c Department of Anesthesiology , University of Cincinnati College of Medicine , Cincinnati , OH , USA.
authors: James C
authors: JC
authors: Phero
mesh_terms: D065634:Cerebrospinal Fluid Leak / Q000209:etiology*; D003051:Cochlea / Q000601:surgery; D019929:Cochlear Implantation / Q000009:adverse effects*; D003054:Cochlear Implants / Q000009:adverse effects; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D033162:Incidental Findings; D007431:Intraoperative Complications / Q000209:etiology*; D008875:Middle Aged; D012640:Seizures / Q000209:etiology*; D014723:Vestibular Aqueduct / Q000002:abnormalities / Q000000981:diagnostic imaging
keywords: CSF Leak; Cochlear Implant; Enlarged Vestibular Aqueduct; Perilymph Gusher; Seizure