case_images: PMC11762878_01
case_images: Postoperative progress chart. POD, postoperative day; EEG, electroencephalogram; B and S, burst suppression; CT, computed tomography; MRI, magnetic resonance imaging
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case_images: PMC11762878_01_44215_2025_189_Fig1_HTML.jpg
case_images: Fig1
case_images: The postoperative progress chart is shown in Fig. 1. Tonic-clonic seizures occurred on the day of surgery when sedation was reduced and ceased with further sedation using propofol.
case_images: Electroencephalogram during convulsions. Generalized high-amplitude sharp waves are seen
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case_images: PMC11762878_01_44215_2025_189_Fig2_HTML.jpg
case_images: Fig2
case_images: Upon the discontinuation of propofol, generalized epileptiform activity started from the right temporal lobe, accompanied by tonic-clonic seizures (Fig. 2).
case_images: Electroencephalogram after convulsion termination. Generalized 2-Hz slow waves are observed. We consider this to be rhythmic delta activity below 4 Hz, and in combination with the absence of seizures, the patient was diagnosed with nonconvulsive epileptic seizures
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case_images: PMC11762878_01_44215_2025_189_Fig3_HTML.jpg
case_images: Fig3
case_images: The motor symptoms spontaneously ceased within 2-3 min, but consciousness did not improve, and high-amplitude slow waves resembling rhythmic delta activity persisted (Fig. 3), leading to the diagnosis of NCSE.
case_images: Electroencephalography during deep sedation. Sedation is administered using a combination of propofol and midazolam. Appropriate sedation depth is maintained to achieve burst suppression
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case_images: PMC11762878_01_44215_2025_189_Fig4_HTML.jpg
case_images: Fig4
case_images: Propofol was reduced while maintaining burst suppression on EEG (Fig. 4).