Abstracts

Rationale: Seizure is a very rare complication after laminectomy for spinal root compression. It may be due to the anesthetic agents, pneumocephalus or intracranial hypotension. Pneumocephalus is described as the presence of air in the intracranial cavity which may be associated with spinal causes such as lumbar puncture, infections, tumors, spinal trauma and surgery. Herein, we report an interesting case of a 40-year-old woman who presented with epilepsia partialis continua after lumbar spinal surgery because of pneumocephalus. Methods: After L4 and L5 subtotal laminectomy operation the patient had clonic jerks on the left side of the face and left upper limb on the first postoperative day. Brain computed tomography scan was performed rapidly and it revealed significant diffuse pneumocephalus involving right temporal lobe, fourth ventricle and perimesencephalic area. The patient was transferred to the intensive care unit for observation and treatment with 100% oxygen and antiepileptics. After the treatment with benzodiazepines and phenytoin for 12 hours, she was seizure free. She ambulated well after 24 hours of bed rest, hydration and close monitoring and was discharged home on postoperative day 3 with no neurological deficits. There were no long-term complains noted on her follow-up appointments. Results: There are multiple reports of symptomatic pneumocephalus after spinal lumbar procedures in the literature. But seizure is a rare complication after spinal surgery. Conclusions: Symptoms of pneumocephalus are often nonspecific and various. Although seizure is extremely rare after spinal surgery, it should be kept in mind to avoid serious consequences.