The Consideration of Anesthesia Technique in Caesarian Section Procedure of Pregnant

Women with History Epilepsy: A Case Report

Background: Epilepsy is a neurological disorder associated with cognitive impairment that

depends on the frequency of seizures. The incidence of epilepsy continues to increase every year
even close to the prevalence of stroke. Epilepsy prevalence of 0.5-1% of the entire population. The
incidence of epilepsy can occur in all populations including pregnant women with a percentage of
0.3-0.6%.

Case report

A 31-year-old woman with a diagnosis of G4P3003 38 single weeks of life with symptomatic
epilepsy on treatment and post-resection oligodendroglioma. Therefore, the patient was planned
to undergo a sectional procedure. Patients were symptomatic epilepsy sufferers diagnosed since
early 2018. Epileptic dignosis was established from the presence of epileptiform waves on EEG
examination before tumor resection surgery. Patients treated with anti-epileptic drugs namely
carbamazepine 200 mg every 12 hours and folic acid 400 micrograms every 24 hours until now .
The patient will undergo sectiocesaria surgery with spinal block anesthetic technique.
Premedication given midazolam 1 mg intravenously, dexamethasone 10 mg intravenously, and
dipenhidramine 10 mg intravenously. For spinal blocks, patients were given a 5% 12.5 mg
bupivacaine heavy drug via intrathecal. Birth babies with apgar score 8-9. post-surgery is carried
out with possible close monitoring of seizures, vital signs, and new neurological deficits.
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Discussion: Preoperative assessment in patients with epilepsy is very important, namely history
regarding the type and pattern of seizures, use of anti-epileptic drugs. Durante operation
monitoring is very important to do, namely for monitoring of seizures, the effect of anesthesia on
the emergence of seizures and antiepileptic drugs taken by mouth

Conclusion: Patients with epilepsy can be treated using spinal block technique as a safe choice that
does not interfere with the pharmacodynamics and pharmacokinetics of antiepileptic drugs.
Keywords: anesthesia, pregnant women, epilepsy, caesarian section