Abstract
Disorder of consciousness (DOC) has various etiologies. Here, we report
a case in which DOC following general anesthesia was suspected as being
due to the first episode of non-convulsive status epilepticus (NCSE). An
elderly man in his 80s underwent uneventful tumor resection surgery
under general anesthesia for extramammary Paget’s disease. After the
procedure, he regained consciousness following anesthesia
discontinuation, and was extubated. Soon after extubation, however,
although his respiratory status remained stable, his level of
consciousness deteriorated to a Glasgow Coma Scale (GCS) score of
E1V1M1. Head computed tomography and magnetic resonance imaging scans
indicated no abnormal findings. Subsequently, involuntary movements were
noted in his left upper limb. Suspecting an epilepsy episode, diazepam
was administered, leading to an improvement in the level of
consciousness (GCS: E4V5M6). Based on the improvement in consciousness
after diazepam administration, we strongly suspected NCSE.
Keywords: Disorder of consciousness (DOC), electroencephalogram
(EEG), non-convulsive status epilepticus (NCSE), general anesthesia