Perioperative Anesthetic Management of Epileptic Parturient Patients

Abstract

Epilepsy is one of the most common chronic neurological diseases differ from seizures or convulsions by definition requiring occurrence of 2 unreactive seizures more than 24 hours apart, more common in males and low socioeconomic state. Pathophysiology of epilepsy includes hyper-synchronous electrical signals that mediated mainly by glutamate or lack of inhibition mediated by GABA, discharge may originate from one cerebral hemisphere called focal seizure or 2 cerebral hemispheres with thalamic circuit affection for generation of diffuse and bilateral discharge. Action potential is basic for neuronal excitability occurs in all or none pattern, Na + influx and K+ outflux contribute in change of membrane potential (depolarization). Etiology for epilepsy includes idiopathic most common cause only 2/3 related to specific cause, genetically determined, trauma, tumor, infection, cerebral degeneration, cerebrovascular diseases, multiple sclerosis and metabolic causes.