Tonic-clonic seizure after unrecognized unintentional dural puncture

C R Taylor; J E Mehdiratta; M Yurashevich; J E Dominguez; A S Habib

doi:10.1016/j.ijoa.2020.07.010

Tonic-clonic seizure after unrecognized unintentional dural puncture

Int J Obstet Anesth. 2020 Nov:44:77-80. doi: 10.1016/j.ijoa.2020.07.010. Epub 2020 Jul 25.

Authors

C R Taylor¹, J E Mehdiratta², M Yurashevich², J E Dominguez², A S Habib²

Affiliations

¹ Duke University Hospital, Durham, NC, USA. Electronic address: cameron.r.taylor@duke.edu.
² Duke University Hospital, Durham, NC, USA.

PMID: 32810652
DOI: 10.1016/j.ijoa.2020.07.010

Abstract

Patients who suffer an unintentional dural puncture have a high risk of developing a post-dural puncture headache. Other neurologic complications have been reported, but seizure is rarely seen. We present a case of a 21-year-old primigravida who experienced an unrecognized unintentional dural puncture that ultimately resulted in a tonic-clonic seizure from intracranial hypotension one week following the dural breach. Her trachea was intubated and she was transferred to the intensive care unit. Two epidural blood patches, performed by neuroradiologists, were needed before the patient experienced complete resolution of her headache. During the re-admission, she also experienced a pulmonary embolus which further lengthened her hospital stay.

Keywords: Epidural blood patch; Post-dural puncture headache; Tonic-clonic seizure.

Publication types

Case Reports

MeSH terms

Adult
Analgesia, Epidural / adverse effects*
Anesthesia, Obstetrical / adverse effects*
Blood Patch, Epidural / methods
Female
Humans
Intracranial Hypotension / complications*
Intracranial Hypotension / therapy
Post-Dural Puncture Headache / etiology*
Post-Dural Puncture Headache / therapy
Pregnancy
Seizures / etiology*
Seizures / therapy
Spinal Puncture / adverse effects*
Young Adult