title: Induction of partial epileptic seizures by flumazenil.
abstract: OBJECTIVE
  This study addressed the efficacy of flumazenil (FMZ) to induce or activate interictal or ictal epileptic discharges in patients with medically intractable partial epilepsies.
  
  
  METHODS
  Flumazenil, 1 mg, was injected intravenously in 67 patients undergoing presurgical monitoring for epilepsy surgery, 49 of whom had been treated with benzodiazepines (BZDs) before flumazenil was given. Continuous video electroencephalogram (EEG) monitoring with surface or intracranial electrodes was used to evaluate interictal EEG activity, ictal discharges, and the occurrence and semiology of clinically manifest epileptic seizures.
  
  
  RESULTS
  Interictal epileptiform potentials did not change in frequency or distribution after FMZ. In patients not pretreated with BZDs, epileptic seizures could not be provoked. In eight of the 49 patients pretreated with BZDs, epileptic seizures occurred within 30 min of FMZ application. Seizure semiology and regional EEG onset were identical to seizures recorded without FMZ. Patients operated on according to seizure-onset localization with FMZ had a >75% reduction in seizure frequency or became seizure free.
  
  
  CONCLUSIONS
  Seizure induction by FMZ seems to be a valid method for evaluating seizure semiology and localization of the seizure-onset zone during presurgical monitoring of patients with medically intractable localization-related epilepsies.
authors.affiliation: Clinic of Epileptology, University of Bonn, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Schulze-Bonhage
authors.forename: C E
authors.initials: CE
authors.lastname: Elger
mesh_terms: D000927:Anticonvulsants / Q000037:antagonists & inhibitors* / Q000493:pharmacokinetics / Q000627:therapeutic use; D001569:Benzodiazepines / Q000037:antagonists & inhibitors* / Q000493:pharmacokinetics / Q000627:therapeutic use; D004567:Electrodes, Implanted; D004569:Electroencephalography / Q000187:drug effects / Q000706:statistics & numerical data*; D004828:Epilepsies, Partial / Q000139:chemically induced* / Q000175:diagnosis* / Q000188:drug therapy; D005442:Flumazenil / Q000008:administration & dosage / Q000494:pharmacology; D058787:GABA-A Receptor Antagonists; D006760:Hospitalization; D006801:Humans; D007275:Injections, Intravenous; D011963:Receptors, GABA-A / Q000187:drug effects / Q000378:metabolism; D012189:Retrospective Studies; D014743:Videotape Recording
chemical_list: D000927:Anticonvulsants; D058787:GABA-A Receptor Antagonists; D011963:Receptors, GABA-A; D001569:Benzodiazepines; D005442:Flumazenil