Hostname: page-component-745bb68f8f-grxwn Total loading time: 0 Render date: 2025-01-24T05:48:31.148Z Has data issue: false hasContentIssue false
  • English
  • Français

Anesthesia for Temporal Lobe Epilepsy Surgery

Published online by Cambridge University Press:  02 December 2014

Ian A. Herrick  and
Adrian W. Gelb
Ian A. Herrick
Affiliation:
Department of Anesthesia, University of Western Ontario, London Health, Sciences Centre, London, Ontario, Canada.
Adrian W. Gelb
Affiliation:
Department of Anesthesia, University of Western Ontario, London Health, Sciences Centre, London, Ontario, Canada.
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Anesthetic considerations for temporal lobectomy for refractory epilepsy include ensuring a safe and comfortable perioperative experience for the patient, providing suitable operating conditions for the surgeon, avoiding interference with intraoperative electrocorticographic (ECoG) recordings and facilitating intraoperative functional cortical mapping, if performed. Providing the conditions that simultaneously meet these requirements, using general anesthesia or local anesthesia with sedation, remains a significant challenge for the neuroanesthetist. We review issues pertinent to the choice of anesthetic technique for these procedures.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 27 , Issue S1: Canadian Temporal Lobe Epilepsy Surgery Workshop , May 2000 , pp. S64 - S67
Copyright
Copyright © The Canadian Journal of Neurological 2000

References

1. Girvin, J. Neurosurgical considerations and general methods forcraniotomy under local anesthesia. Internat Anesthesiol Clin 1986;24:89–113.Google Scholar
2. Pinosky, M, Fishman, R, Reeves, S, et al. The effect of bupivacaine skull block on the hemodynamic response to craniotomy. Anesth Analg 1996;83:1256–1261.Google Scholar
3. Craen, RA, Herrick, IA. Seizure surgery: general considerations andspecific problems associated with awake craniotomy. Anesthesiol Clin North Amer 1997;15:655–672.Google Scholar
4. Herrick, IA. Seizure activity and anesthetic agents and adjuvants. In: Albin, MS (ed), Textbook of Neuroanesthesia with Neurological and Neurosciences Perspectives. New York: McGraw-Hill, 1997: 625–642.Google Scholar
5. Modica, PA, Tempelhoff, R, White, PF. Pro-and anticonvulsanteffects of anesthetics (Parts I and II). Anesth Analg 1990;70:303–315 and 433–444.Google Scholar
6. Gignac, E, Manninen, P, Gelb, A. Comparison of fentanyl, sufentaniland alfentanil during awake craniotomy for epilepsy. Can J Anaesth 1993;40:421–424.Google Scholar
7. Manninen, P, Contreras, J. Anesthetic considerations for craniotomyin awake patients. Internat Anesthesiol Clin 1986;24:157–174.Google Scholar
8. Archer, D, McKenna, J, Morin, L, Ravussin, P. Conscious-sedationanalgesia during craniotomy for intractable epilepsy: a review of 354 consecutive cases. Can J Anaesth 1988;35:338–344.Google Scholar
9. Drummond, J, Iragui-Madoz, V, Alksne, J, Kalkman, C. Maskingepileptiform activity by propofol duringseizure surgery.Anesthesiology 1992;76:652–654.Google Scholar
10. Silbergeld, D, Mueller, W, Colley, P, Ojemann, G, Lettich, E. Use ofpropofol (Diprivan) for awake craniotomies: technical note. Surg Neurol 1992;38:271–272.Google Scholar
11. Herrick, I, Craen, R, Gelb, A, et al. Propofol sedation during awakecraniotomy for seizures: patient-controlled administration versus neurolept analgesia. Anesth Analg 1997;84:1285–1291.Google Scholar
12. Johnson, KB, Egan, TD. Remifentanil and propofol combination forawake craniotomy: case report with pharmacokinetic simulations. J Neurosurg Anesth 1998;10:25–29.Google Scholar
13. Sneyd, JR. Propofol and epilepsy. Br J Anaesth 1999;82:168–169.Google Scholar
14. Rampil, I, Lopez, C, Laxer, K, Barbaro, N. Propofol sedation maydisrupt interictal epileptiform activity from a seizure focus. Anesth Analg 1993;77:1071–1073.Google Scholar
15. Pitt-Miller, P, Elcock, B, Maharaj, M. The management of statusepilepticus with a continuous propofol infusion. Anesth Analg 1994;78:1193–1194.Google Scholar
16. Yanny, H, Christmas, D. Propofol infusions for status epilepticus. Anaesthesia 1988;43:514.Google Scholar
17. Smith, M, Smith, S, Scott, C, Harkness, W. Activation of theelectrocorticogram by propofol during surgery for epilepsy. Br JAnaesth 1996;76:499–502.Google Scholar
18. Wang, B, Bai, Q, Jiao, X, Wang, E, White, P. Effect of sedative andhypnotic doses of propofol on the electroencephalogram of patients with and without epileptic activity. Anesth Analg 1997;84:S375(abst).Google Scholar
19. Bevan, J. Propofol-related convulsions. Can J Anaesth 1993;40:805–809.Google Scholar
20. Orser, B. Propofol-induced neuroexcitation and receptordesensitization. Can J Anaesth 1994;41:366–371.CrossRefGoogle Scholar
21. Herrick, I, Craen, R, Gelb, A, et al. Propofol sedation during awakecraniotomy for seizures: electrocorticographic and epileptogenic effects. Anesth Analg 1997;84:1280–1284.Google Scholar
22. Engel, J Jr. Alternate therapy. In: Engel, J Jr (ed). Seizures and Epilepsy. Philadelphia: F A Davis, 1989: 443–474.Google Scholar
23. Wass, CT, Rajala, MM, Hughes, JM, et al. Long-term follow-up ofpatients treated surgically for medically intractable epilepsy: results in 291 patients treated at Mayo Clinic between July 1972 and March 1985. Mayo Clin Proc 1996;71:1105–1113.Google Scholar
24. Watts, A, Herrick, IA, McLachlan, RS, et al. Electrocorticographiceffects of sevoflurane and isoflurane in patients with seizuredisorders. Anesth Analg 1999;89:1275–1281.Google Scholar
25. Tempelhoff, R, Modica, PA, Bernardo, KL, Edwards, I. Fentanyl-induced electrocorticographic seizures in patients with complex partial epilepsy. J Neurosurg 1992;77:201–208.Google Scholar
26. Cascino, GD, So, EL, Sharbrough, FW, et al. Alfentanil-inducedepileptiform activity in patients with partial epilepsy. J Clin Neurophysiol 1993;10:520–525.Google Scholar
27. Keene, DL, Roberts, D, Splinter, WM, Higgins, M, Ventureyra, E. Alfentanil mediated activation of epileptiform activity in the electrocorticogram during resection of epileptogenic foci. Can J Neurol Sci 1997;24:37–39.Google Scholar
28. Manninen, PH, Burke, SJ, Wennberg, R, Lozano, AM, El Beheiry, H. Intraoperative localization of an epileptogenic focus with alfentanil and fentanyl. Anesth Analg 1999;88:1101–1106.Google ScholarPubMed
29. Kanazawa, O, Blume, WT, Girvin, JP. Significance of spikes attemporal lobe electrocorticography. Epilepsia 1996;37:50–55.Google Scholar