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Epilepsy is a common disease of the nervous system and has a global morbidity rate of 0.5-2% [1]. There are about 50 million individuals worldwide diagnosed as epileptic [2]. There are approximately 9 million epilepsy patients in China, and this number is increasing at a rate of 200 to 400 thousand per year. Among these patients, approximately 20-25% of patients suffer from drug-resistant epilepsy and are potential surgery recipients. Even for epilepsy patients without drug resistance, surgery is often needed due to accompanying diseases, such as tumors, vascular malformations or head injuries. Epileptic seizures can undoubtedly be induced by anesthetics. The occurrence of preoperative, intraoperative and postoperative seizures increases the risk and difficulty of surgery. Therefore, understanding the patterns and characteristics of epilepsy, particularly those related to prevention and treatment, is an important method of ensuring the safety of surgery.
Epidemiology
In 2005, Akavipat et al. [3] examined 172,592 patients with or without epilepsy and found that the incidence of anesthetic epileptic seizures is 3.1/10,000. In 2009, Kopp et al. [4] studied 411 cases and proposed that, under local anesthesia, the incidence of seizures in epilepsy patients is 5.8%. In 2010, Niesen et al. [5] performed further research and suggested that, among epilepsy patients, the incidence of anesthetic seizure is 3.4%. Furthermore, these authors also found that, for patients who have suffered seizures within the 4 weeks prior to surgery, the incidence is 18.7%, and for patients who have suffered seizures during the 1 or 2 years prior to surgery, these rates are 12.8 and 3.4%, respectively. Additionally, these authors reported that these rates are 26.3, 18.6 and 12.8% in patients who suffer preoperative seizures more than once a week, more than once a month and more than once a year, respectively.
Epileptic seizures due to anesthetics or anesthesia
Epileptic seizures induced by anesthetics: Anesthetics are effective drugs for the treatment of status epilepticus; however, these drugs can also induce seizures. There have been many cases of seizures induced by different kinds of anesthetics, such as sevoflurane, propofol, methohexital, etc. (Table 1). For example, in 2013, Kim et al. [6] reported a case of a 5-year-old child who had been diagnosed with a simple partial seizure 14 months previously. She took valproate (240 mg/day)...