Focal cooling suppresses spontaneous epileptiform activity without changing the cortical motor threshold.
OBJECTIVE
Focal cerebral cooling has been shown to reduce epileptiform activity in animals. There are, however, few reports of this phenomenon in humans.


METHODS
Electrocorticography was performed before resection of a right frontal tumor in a patient with partial seizures. Cold saline was applied to the interictal spike focus, and its effect on the epileptiform discharges was observed.


RESULTS
Application of cold saline to the spike focus resulted in a transient, complete cessation of spiking. This effect was reproduced with a second application of cold saline. The motor threshold for electrical stimulation remained unchanged during the application of saline.


CONCLUSIONS
In this patient with tumor-related epilepsy, focal cooling of the cortex reproducibly abolished interictal epileptiform discharges without changing the motor threshold to electrical stimulation.
Department of Neurology University of California, San Francisco, San Francisco, California, U.S.A. karkark@itsa.ucsf.edu
Kameel M
KM
Karkar
Paul A
PA
Garcia
Lisa M
LM
Bateman
Matthew D
MD
Smyth
Nicholas M
NM
Barbaro
Mitchel
M
Berger
D000328:Adult; D001254:Astrocytoma / Q000150:complications / Q000601:surgery; D001932:Brain Neoplasms / Q000150:complications / Q000601:surgery; D003080:Cold Temperature; D004056:Differential Threshold; D004558:Electric Stimulation; D004569:Electroencephalography; D004576:Electromyography; D004828:Epilepsies, Partial / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods; D008297:Male; D009044:Motor Cortex / Q000503:physiopathology*; D009068:Movement / Q000502:physiology; D012965:Sodium Chloride
D012965:Sodium Chloride