Multimodal monitoring to aid detection and management of intraoperative seizures: a case report

One of the primary goals in Neuroanesthesia is to preserve cerebral oxygenation and protect the brain from secondary injuries. Seizures have severe implications in the intraoperative period, as it can instigate an increase in cerebral metabolism and oxygen demand, thus causing cerebral hypoxia. Detection of intraoperative seizures is imperative in neurosurgical cases as the ramifications of intracranial hypertension and cerebral hypoxia caused by it can affect patient prognosis and perioperative outcomes. We report a case of detecting intraoperative seizures with the aid of patient state index and near infrared spectroscopy. Multi-modality monitoring aided in the management of a time-sensitive complication, which could otherwise have possibly led to secondary brain insult.