A 2 year old child was put under general anesthesia by plastic surgeon for skin grafting. Just after surgery during recovery she became unconscious, unable to recover and was brought to general ICU where she was resuscitated using ventilators and didn't recover recover for 5 days. She also had a seizure and an MRI was done showing basal ganglion abnormal signaling.
There are some neurotransmitter which are responsible for the excitatory and inhibitory action of brain.these excitatory and inhibitory neurotransmiters are released from ganlia that may be post ganglionic / pre ganglionic region.e.g of excitatory neurotransmitters are acetylcholine,aspartae,glutamate,Adr etc.e.g. of inhibitory neurotransmitters like GABA.
There is imbalance in the excitatory and inhibitory neurotransmitters .so in case of epileptic patients or patients suffering from seizure mainly due to excess secretion of aspartate/glutamate or due to less secretion of GABA.
Most probably she has been hypoxic after surgery either before or during resucitaion before intiubation. That could explain seizures and MRI changes: Hypoxix cerebral damage.
Thanks Hans and swati ..Hans 'sir i also thin like that'.thanks a lot,and that hypoxic brain injury i think occur at resucitation.thanks a lot for contribution
and dr swati is also correct that explain the depth of mechanism.
Anesthesia-related hypoxemia is a likely cause of the seizures . The basal ganglia are the most vulnerable areas for hypoxia. Whether you successfully resuscitated after the hypoxic event , the insult in the brain is irreversible if it lasts for more than few minutes. It is not rare unfortunate event in surgery practice.
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