Increased spike frequency during general anesthesia with etomidate for magnetoencephalography in patients with focal epilepsies.
OBJECTIVE
Magnetoencephalography (MEG) is used for focus localization in presurgical evaluation of patients with focal epilepsies. In this proof-of-concept study, general anesthesia with etomidate was used to improve effectiveness of MEG-recordings.


METHODS
MEG-recordings of six patients with focal epilepsy were performed before and after application of etomidate. Spike frequency and localization accuracy of MEG with general anesthesia were compared with spontaneous MEG.


RESULTS
After application of etomidate, an increase in spike frequency occurred in all patients, and movement artifacts were prevented. In one patient, spikes could only be detected by invasive EEG but not by MEG. The results were in accordance with spontaneous MEG or presurgical hypotheses about localizations of neocortical foci in three patients. Dipole localizations were distributed over fronto-temporal areas in three patients with ipsilateral temporo-mesial focus hypotheses.


CONCLUSIONS
Etomidate ameliorated spike yield and stopped movement artifacts during MEG recordings in patients with focal epilepsy. Localization results were especially accurate in patients with neocortical epilepsy.


CONCLUSIONS
These results could facilitate larger studies on the usefulness and safety of general anesthesia with etomidate that record and localize epileptic activity in patients with focal epilepsy by MEG.
Stefan
Hermann
H
Epilepsy Center, Department of Neurology, University Hospital Erlangen, Erlangen, Germany. hermann.stefan@uk-erlangen.de
Heers
Marcel
M
Schmitt
Hubert J
HJ
Rauch
Christophe
C
Kaltenhäuser
Martin
M
Rampp
Stefan
S
D000328:Adult; D018686:Anesthetics, Intravenous / Q000627:therapeutic use; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000187:drug effects* / Q000503:physiopathology* / Q000601:surgery; D004567:Electrodes, Implanted; D004828:Epilepsies, Partial / Q000503:physiopathology* / Q000601:surgery; D005045:Etomidate / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015225:Magnetoencephalography; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D012815:Signal Processing, Computer-Assisted
D018686:Anesthetics, Intravenous; D005045:Etomidate