Etomidate is a hypnotic nonbarbiturate, ultra–short-acting anesthetic agent associated with involuntary muscle movements in 10–70% of patients. These movements can be violent and mimic seizure activity. Etomidate is often administered because of its cardiovascular stabilizing effect. In patients without epilepsy, surface electrode recordings during the myoclonic movements are not associated with epileptiform activity.54
In epilepsy patients, etomidate (0.2 mg/kg) can activate seizure foci within 30 seconds55 and has been used intraoperatively for this purpose.
Despite the lack of evidence that etomidate causes seizures in nonepileptic patients, epileptiform activity occurred in 6 of 30 nonepileptic patients who were induced with etomidate for heart valve replacement.54
Reviewed and revised April 2004 by Steven C. Schachter, MD, epilepsy.com Editorial Board.
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