Myoclonic Seizures After Endoscopic Cervical Disc Surgery: A Rare Complication or Just Coincidence?

Myoclonic Seizures After Endoscopic Cervical Disc Surgery: A Rare Complication or Just Coincidence?

We present a unique case of myoclonic seizures 36 h after endoscopic cervical disc surgery. A 48-year-old female patient underwent posterior endoscopic disc surgery for right C6-C7 disc herniation. The surgery finished without any complications. No dural tear could be detected. 36 h after the surgery the patient developed myoclonic seizures. The MRI did not reveal any mass effect or hemorrhage or any signs of intracranial hypotension, EEG did not show any pathologies. Generalized seizures after spinal procedures are extremely rare and are mostly associated with accidental durotomy-induced intracranial hypotension or pneumocephalus. No plausible cause for the seizure like disturbance of CSF flow, hypovolemia, anesthetic agents, or the irrigation water pressure could be found to explain this pathology. We believe that the cause of the seizure was multifactorial due to a combination of the presence of syringomyelia, surgical manipulation, and water pressure of the endoscope creating an epileptogenic focus on the proximal spinal cord creating a foundation for the later seizure.