Status epilepticus after orthopedic surgery: a clinical analysis of 21 patients

Abstract

Objective To explore the etiology, clinical features and treatment of status epilepticus (SE) after orthopedic surgery and improve the diagnosis and treatment. Methods The data of 21 patients with SE after orthopedic surgery were retrospectively analyzed. Among these 21 patients, 5 with epilepsy before the orthopedic surgery, 4 with acute ischemic cerebrovascular diseases, 3 with fat embolism syndrome, 1 with tumor emboli, 4 with metabolic encephalopathy, 1 with hypoglycemia, 1 with diabetic ketoacidosis and 2 with chronic renal insufficiency were found. Orthopedic surgery was performed on these patients: fracture of the shaft of the femur was found in 8; hip arthroplasty was performed in 7 with fracture of femoral neck; fracture of the shaft of the humerus was noted in 3; giant cell tumors in the lumbar vertebra was found in 1; burst fracture in the thoracic vertebra was found in 1 and amputation was conducted in 1 with diabetic gangrene. Results Diazepam injection was employed to control the seizure in 11 patients with SE and 9 got good effect; valproate sodium injection was also used to control the seizure in 10 patients with SE and 6 showed good results. Conclusions Many reasons can result in the happening of SE after orthopedic surgery. The incidence and death rate of SE can be obviously decreased by good controlling the physical conditions in the perioperative period. The anti-epilepsy drugs should be chosen according to the age and physical conditions of the patient and the side effects of the anti-epilepsy drugs. Key words: Status epilepticus; Orthopaedics operation