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May 1990

Seizures Following Carotid Endarterectomy

Author Affiliations

From the Department of Neurology, University of Rochester (NY) (Drs Kieburtz and Moxley), and the Department of Surgery, Division of Vascular Surgery, State University of New York at Buffalo (Dr Ricotta).

Arch Neurol. 1990;47(5):568-570. doi:10.1001/archneur.1990.00530050092017

• Cerebral infarction, headache, and hypertension are well-known complications of carotid endarectomy (CEA). Seizures are a less frequent, but important complication. We describe eight patients with focal and generalized seizures following CEA. Seizures occurred 6 to 13 days after CEA. All began as focal motor seizures contralateral to the side of the CEA, and six patients developed generalized tonoclonic seizures. Lorazepam and phenytoin sodium controlled the seizures. Five patients without evidence of stroke on computed tomographic scan were normal in follow-up and had no further seizures. The other three patients had mild deficits. One developed a chronic seizure disorder. The pathogenesis of this syndrome following CEA remains unclear, but may involve cerebral hyperperfusion, cerebral embolization, or both.