Studija slučaja
Sufentanil-Associated Seizure-Like Tonic–Clonic Activity in a Patient with Pituitary Macroadenoma and Hypopituitarism: A Case Report
Ana Piršljin
orcid.org/0000-0002-6836-3997
; Department of Anesthesiology and ICU, University Hospital Centre Zagreb, Zagreb, Croatia
*
Vasilije Stambolija
; Department of Anesthesiology and ICU, University Hospital Centre Zagreb, Zagreb, Croatia
Dinko Tonković
; Department of Anesthesiology and ICU, University Hospital Centre Zagreb, Zagreb, Croatia
* Dopisni autor.
Sažetak
Background: Opioid-associated convulsive episodes are exceedingly rare during anesthesia induction. When they occur, they typically manifest within seconds of intravenous opioid administration as generalized tonic–clonic movements without epileptiform EEG activity, suggesting a pharmacodynamic origin.
> Case: We present a 67-year-old male with a pituitary macroadenoma and panhypopituitarism who developed generalized tonic–clonic seizure-like activity immediately after receiving 20 μg of sufentanil during anesthesia induction. The episode lasted approximately 30 seconds, accompanied by a blood pressure spike to 220/110 mmHg and oxygen desaturation to 65%. It resolved spontaneously with supportive care. Surgery was postponed, and the patient was monitored in the intensive care unit; later that day, neurological examination and EEG results showed no acute abnormalities.
> Conclusions: Even small doses of sufentanil may rarely be associated with seizure-like motor phenomena during anesthesia induction. Because EEG was not recorded during the event, definitive differentiation between an epileptic seizure and opioid-induced nonepileptic motor activity was not possible. Underlying endocrine dysfunction may have represented an additional vulnerability, although this association remains speculative.
Ključne riječi
Sufentanil; Seizure-like activity; Hypopituitarism; Pituitary macroadenoma; Adrenal insufficiency; Anesthesia induction
Hrčak ID:
348899
URI
Datum izdavanja:
6.7.2026.
Posjeta: 0 *