| Magnetoencephalography using total intravenous anesthesia in pediatric patients with intractable epilepsy: lesional vs nonlesional epilepsy. | |
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MedLine Citation:
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PMID: 18842368 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: Magnetoencephalography (MEG) provides source localization of interictal spikes. We use total intravenous anesthesia (TIVA) with propofol to immobilize uncooperative children. We evaluate the effect of TIVA on interictal spikes in children who have intractable epilepsy with or without MRI lesions. METHODS: We studied 28 children (3-14 years; mean, 6.6). We intravenously administered propofol (30-60 microg/kg/min) to record MEG with simultaneous EEG. We evaluated MEG spike sources (MEGSSs). We compared spikes on simultaneous EEG under TIVA with those on scalp video-EEG without TIVA. RESULTS: There was a significant decrease in frequent spikes (10 patients, 36%) on simultaneous EEG under TIVA compared to those (22 patients, 79%) on scalp video-EEG without TIVA (P<0.01). MEGSSs were present in 21 (75%) of 28 patients. Clustered MEGSSs occurred in 15 (83%) of 18 lesional patients but in 3 (30%) of 10 nonlesional patients (P<0.05). MEGSSs were more frequently absent in nonlesional (6 patients, 60%) than lesional (one patient, 5%) patients (P<0.01). Thirteen patients with MRI and/or histopathologically confirmed neuronal migration disorder most frequently showed clustered MEGSSs (11 patients, 85%) compared to those of other lesional and nonlesional patients. CONCLUSION: Propofol-based TIVA reduced interictal spikes on simultaneous EEG. TIVA for MEG still had utility in identifying spike sources in a subset of pediatric patients with intractable epilepsy who were uncooperative and surgical candidates. In lesional patients, MEG under TIVA frequently localized the clustered MEGSSs. Neuronal migration disorders were intrinsically epileptogenic and produced clustered MEGSSs under TIVA. Nonlesional patients often had no MEGSS under TIVA. |
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Authors:
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Ayataka Fujimoto; Ayako Ochi; Katsumi Imai; Derrick Chan; Rohit Sharma; Amrita Viljoen; Bill Chu; Stephanie Holowka; Sheelagh M Kemp; Sylvester H Chuang; Akira Matsumura; Satoshi Ayuzawa; O Carter Snead; Hiroshi Otsubo |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't Date: 2008-10-07 |
Journal Detail:
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Title: Brain & development Volume: 31 ISSN: 1872-7131 ISO Abbreviation: Brain Dev. Publication Date: 2009 Jan |
Date Detail:
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Created Date: 2008-12-16 Completed Date: 2009-02-19 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7909235 Medline TA: Brain Dev Country: Netherlands |
Other Details:
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Languages: eng Pagination: 34-41 Citation Subset: IM |
Affiliation:
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The Division of Neurology, Department of Paediatrics, The Hospital for Sick Children and The University of Toronto, Toronto, Ont., Canada M5G 1X8. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Action Potentials
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drug effects Adolescent Anesthesia, Intravenous / methods Anesthetics, Intravenous / administration & dosage, pharmacology Brain / pathology, physiopathology* Brain Mapping / methods Child Child, Preschool Electroencephalography / methods Epilepsies, Partial / diagnosis, physiopathology Epilepsy / classification, diagnosis, physiopathology* Epilepsy, Generalized / diagnosis, physiopathology Female Humans Magnetic Resonance Imaging Magnetoencephalography / methods* Male Piperidines / administration & dosage, pharmacology Propofol / administration & dosage, pharmacology* Seizures / classification, diagnosis, physiopathology |
| Chemical | |
Reg. No./Substance:
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0/Anesthetics, Intravenous; 0/Piperidines; 132875-61-7/remifentanil; 2078-54-8/Propofol |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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