Somatosensory-evoked fields on magnetoencephalography for epilepsy infants younger than 4 years with total intravenous anesthesia.
OBJECTIVE
Patients must remain immobile for magnetoencephalography (MEG) and MRI recordings to allow precise localization of brain function for pre-surgical functional mapping. In young children with epilepsy, this is accomplished with recordings during sleep or with anesthesia. This paper demonstrates that MEG can detect, characterize and localize somatosensory-evoked fields (SEF) in infants younger than 4 years of age with or without total intravenous anesthesia (TIVA).


METHODS
We investigated the latency, amplitude, residual error (RE) and location of the N20m of the SEF in 26 infants (mean age=2.6 years). Seventeen patients underwent TIVA and 9 patients were tested while asleep, without TIVA.


RESULTS
MEG detected 44 reliable SEFs (77%) in 52 median nerve stimulations. We found 27 reliable SEFs (79%) with TIVA and 13 reliable SEFs (72%) without TIVA. TIVA effects included longer latencies (p<0.001) and lower RE (p<0.05) compared to those without TIVA. Older patients and larger head circumferences also showed significantly shorter latencies (p<0.01).


CONCLUSIONS
TIVA resulted in reliable SEFs with lower RE and longer latencies.


CONCLUSIONS
MEG can detect reliable SEFs in infants younger than 4 years old. When infants require TIVA for MEG and MRI acquisition, SEFs can still be reliably observed.
Bercovici
Eduard
E
Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, Ont., Canada M5G-1X8.
Pang
Elizabeth W
EW
Sharma
Rohit
R
Mohamed
Ismail S
IS
Imai
Katsumi
K
Fujimoto
Ayataka
A
Ochi
Ayako
A
Viljoen
Amrita
A
Chu
Bill
B
Holowka
Stephanie
S
Chuang
Sylvester H
SH
Kemp
Sheelagh M
SM
Rutka
James T
JT
Carter Snead
O
O
Otsubo
Hiroshi
H
D000704:Analysis of Variance; D000758:Anesthesia / Q000379:methods*; D000771:Anesthesia, Intravenous / Q000379:methods*; D001931:Brain Mapping; D016009:Chi-Square Distribution; D002675:Child, Preschool; D004558:Electric Stimulation / Q000379:methods; D004827:Epilepsy / Q000175:diagnosis* / Q000503:physiopathology*; D005073:Evoked Potentials, Somatosensory / Q000187:drug effects / Q000502:physiology*; D005260:Female; D006801:Humans; D007223:Infant; D015225:Magnetoencephalography; D008297:Male; D008475:Median Nerve / Q000503:physiopathology / Q000528:radiation effects; D011930:Reaction Time