Seizures following carotid endarterectomy
K. Kieburtz, J. J. Ricotta and R. T. Moxley 3rd
Department of Neurology, University of Rochester, NY 14642.
Cerebral infarction, headache, and hypertension are well-known
complications of carotid endarectomy (CEA). Seizures are a less frequent,
but important complication. We describe eight patients with focal and
generalized seizures following CEA. Seizures occurred 6 to 13 days after
CEA. All began as focal motor seizures contralateral to the side of the
CEA, and six patients developed generalized tonoclonic seizures. Lorazepam
and phenytoin sodium controlled the seizures. Five patients without
evidence of stroke on computed tomographic scan were normal in follow-up
and had no further seizures. The other three patients had mild deficits.
One developed a chronic seizure disorder. The pathogenesis of this syndrome
following CEA remains unclear, but may involve cerebral hyperperfusion,
cerebral embolization, or both.
