Neurologic Disorders and Anesthesia

Neurologic complications after anesthesia are relatively uncommon, but can be severe. Delayed arousal and postoperative cognitive dysfunction may follow general anesthesia. It is important in these situations to discriminate between the effects of anesthesia and alternative explanations. Neuropathy and transient gluteal and leg pain are the most frequent complications of regional anesthesia; headache from cerebrospinal fluid leak and paraparesis related to epidural hematoma may also occur. Seizures are infrequent after general or regional anesthesia, and anesthesia can generally be safely administered to most patients with epilepsy. Patients with neurodegenerative and neuromuscular conditions may be at risk of specific complications and require adjustment of the anesthesia plan. Anesthetic agents themselves can be used in the neurointensive care unit to treat refractory status epilepticus or intracranial hypertension.