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During epileptic activity, increases in the CMR may be extreme, whereas regionally, after brain injury and globally with coma, the CMR may be substan- tially reduced.
Ketamine can elicit seizures in patients with an epileptic diathesis.216 Depth electrode recordings in epileptic patients have revealed the occurrence of isolated subcortical seizure activity originating in the limbic and thalamic areas during ketamine anesthesia and demonstrated that this subcortical activation may not be reflected in surface EEG recordings.
Etomidate frequently produces myoclonus that is not asso- ciated with epileptiform activity on the EEG.219 A single instance of severe, sustained myoclonus immediately after anesthesia with etomidate by infusion has been reported.220 Etomidate has also been shown to precipitate generalized epileptic EEG activity in epileptic patients,221 and its use in this population should probably be avoided.
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