Q: Why Cisatracurium should be use with caution in patients with history of severe epilepsy?


Answer: One of the metabolite of Cisatracurium after Hofmann elimination is laudanosine, which is  a modest CNS stimulant with epileptogenic activity and can readily crosses the blood–brain barrier.  It is not a clinical danger but in patients with severe history of epilepsy, it may help to keep this in mind.