Activation procedures are used to elicit epileptic activity. Hyperventilation and photic stimulation are commonly used activation procedures. Hyperventilation is contraindicated in cerebrovascular disease. The normal hyperventilation response consists of a high-amplitude, frontally dominant, generalized slowing (called buildup). This is age dependent and may be absent in older individuals. Hyperventilation provokes absence seizures in childhood absence epilepsy (CAE). Prolonged buildup may be seen in Moya-Moya disease. Photic stimulation normally results in symmetric, occipital dominant, repetitive sharps at the flash frequency or a slower harmonic (called driving). Photo paroxysmal response consists of induction of epileptic discharges with photic stimulation, while photo convulsive response results from a seizure elicited during photic stimulation.

This chapter provides anand in-depth review of the Moya-Moya Syndrome and surgical correction. The authors describe disorders commonly associated with Moya-Moya Disease. The angiographic staging as well as medical and surgical options are presented. A thorough discussion on the perioperative evaluation and anesthetic considerations for this complex disease is presented to the reader.