Tonic-clonic seizure after unrecognized unintentional dural puncture

Patients that suffer an unintentional experiencing inadvertent dural puncture have a high risk of developing a post-dural puncture headache. Other neurologic complications have been reported, but seizure is rarely seen. We present a case of a 21-year-old primigravida who experienced an unintentional unrecognized dural puncture that ultimately resulted in a tonic-clonic seizure from intracranial hypotension one week following the dural breach. Her trachea was intubated and she was transferred to the intensive care unit. Two epidural blood patches, performed by neuroradiologists, were needed before the patient experienced complete resolution of her headache. During the re-admission, she also experienced a pulmonary embolus which further lengthened her hospital stay.

Keywords: Epidural blood patch; Post-dural puncture headache; Tonic-clonic seizure.