None of the muscle relaxants used in clinical anesthesia has been reported to cause epileptiform activity or seizures, nor have anticonvulsant properties been reported in humans. Accumulation of laudanosine, a metabolite of atracurium, may slightly decrease the seizure threshold.95
Resistance to metocurine96 and atracurium or vecuronium-induced97 neuromuscular blockade has been demonstrated in patients who chronically receive phenytoin. Patients treated with chronic anticonvulsant therapy recovered from pipecuronium more rapidly than nonmedicated patients. Furthermore, there seems to be a dose-effect relationship between the number of anticonvulsants received and a decreased time to recovery from pipecuronium neuromuscular blockade.98
Anticholinesterases used in clinical anesthetic practice have not been reported to cause or stop seizures.
Atropine can reduce abnormal discharges on the EEGs of patients with epilepsy.99 It can also block spontaneous and hyperventilation-induced absence seizures.100 These effects are probably related to its central anticholinergic action.
Reviewed and revised April 2004 by Steven C. Schachter, MD, epilepsy.com Editorial Board.
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