Looking Past the Tip of the Iceberg: A Case Series on Perioperative Seizures

Epilepsy is one of the most commonly encountered neurological disorders which may present due to abnormally high levels of neuronal discharge. An anaesthetist may have to deal with seizures perioperatively as well as in intensive care units. Many times, these patients might not be diagnosed with pre-existing epilepsy and a seizure would be precipitated for the first time under anaesthesia. We present a series of three cases with no significant comorbidities or history of epilepsy presenting with seizures during extubation after general anaesthesia. We have systematically reviewed various possible conditions which may arise perioperatively, leading to a reduced seizure threshold. Being aware of these risk factors will help the anaesthesiologists to be more vigilant and better prepared to manage seizures in patients with or without a past history of epilepsy.