Apparent focal motor seizure with a jacksonian march induced by fentanyl: a case report and review of the literature.

This report describes an unusual presentation of focal motor activity resembling Jacksonian march, which developed during fentanyl induction of general anesthesia. Simultaneous spectral-edge activity recording of electroencephalography (EEG) failed to show evidence of an epileptic focus. A negative history of previous seizures, as well as failure to show postoperative postictal symptoms or seizure activity by 16-lead EEG, suggested a myoclonic rather than epileptic nature of the observed muscle activity. Pertinent literature and current theories regarding opioid-induced seizures are discussed.