A patient who had undergone the extraction of impacted wisdom teeth under general anesthesia exhibited agitation and generalized convulsions and was diagnosed postoperatively as having epilepsy. The patient was a 21-year-old woman with a history of bilateral meniscal injury and hyperthyroidism. Anesthesia was administered with propofol and remifentanil, and no notable events occurred during the operation. When the anesthesia was stopped after surgery and attempts were made to wake the patient, she exhibited sudden body movements and did not respond to verbal commands. Initially, tracheal tube irritation was assumed to have occurred ; thus, the patient was extubated and we waited for the agitation to settle. After extubation, however, the patient continued not to respond to verbal commands. The degree of agitation was approximately +2 on the Richmond Agitation-Sedation Scale (RASS) and decreased to approximately RASS +1 after the administration of midazolam (2 mg). The patient was returned to the ward thereafter. Immediately after the patient returned to the ward, her body movements re-intensified, she began to hyperventilate, and generalized convulsions occurred a few minutes later. The convulsions disappeared with the intravenous administration of diazepam but recurred intermittently throughout that day. Thus, a neurologist prescribed diazepam and levetiracetam for the convulsions and the recovery of the impaired consciousness, respectively. An electroencephalography study revealed high-amplitude sharp waves and phase reversal in the right frontal region. The patient’s medical history was reassessed, revealing an incident that had occurred one year previously when the patient had lost consciousness and experienced a twilight state. She was diagnosed as having epilepsy and began receiving treatment.
