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Seizures

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Seizure activity, both partial type and tonic–clonic seizures, represents abnormal CNS excitation. Because anesthetic drugs act by causing depression of the CNS, seizure activity during an anesthetic procedure is unlikely to occur. In patients with seizure disorders, however, seizures may occur in the preoperative and postoperative periods. Management of seizures involves positioning the patient to avoid injury and loosening tight or restrictive clothing as much as possible. Most seizures will terminate after a few minutes and require no other treatment, though benzodiazepines such as midazolam, lorazepam, or diazepam may be given intravenously or intramuscularly to terminate seizure activity. Since patients will typically become hypoxic during the clonic phase of a tonic–clonic seizure, supplemental oxygen may be beneficial in the immediate postictal period.

Management of Complications in Oral and Maxillofacial Surgery

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