Epilepsy Surgery Options in Patients after Brain Hypothermi a


Authors: J. Chrastina 1;  Z. Novák 1;  M. Brázdil 2;  I. Říha 1
Authors‘ workplace: Neurochirurgická klinika LF MU a FN u sv. Anny v Brně, 2Centrum pro epilepsie, I. neurologická klinika LF MU a FN u sv. Anny v Brně 1
Published in: Cesk Slov Neurol N 2009; 72/105(5): 466-469
Category: Short Communication

Overview

Local brain hypothermi a with intraveno us administrati on of an anti epileptic drug was used as a tre atment modality in pati ents suffering from pharmacoresistant epilepsy in the time peri od from the 1960s to the 1980s. Fo ur pati ents after brain hypothermi a with persisting seizures were presented for surgical therapy. Vagus nerve stimulati on was recommended in all pati ents, with 50% seizure reducti on in two pati ents and more than 90% seizure reducti on in one pati ent. Subsequent extensive invasive explorati on enabled palli ative cortical resecti on in the remaining pati ent –  vagus nerve stimulati on non responder –  with some effect on daytime seizures. Besides the period hypotheses discussing the possible mechanisms of the effect of brain hypothermi a, we also revi ewed the data related to the effects of local and general hypothermi a in pati ents with epilepsy. The relati onship of MRI detectable changes and epilepsy must be meticulo usly considered during presurgical work up, beca use these changes may be ca used by pri or hypothermic therapy and its complicati ons.

Key words:
brain hypothermi a –  epilepsy –  vagus nerve stimulati on


Sources

1. Bo uchard G. Basic targets and the different epilepsi es. Acta Ne urochir (Wi en) 1976; 23 (Suppl): 193– 199.

2. Šo urek K. General and local hypothermi a of the brain in the tre atment of intractable epilepsy. In Fusek I, Kunc Z (eds). Proceedings of the fo urth Europe an congress of ne urosurgery. Present limits of ne urosurgery. Prague: Avicenum, Czechoslovak Medical Press 1972.

3. Šo urek K, Trávníček V. General and local hypothermi a of the brain in the tre atment of intractable epilepsy. J Ne urosurg 1970; 33(3): 253– 259.

4. Baldwin M, Farri er R, McDonald F, Ommaya AK. Cerebral depositi on of drugs at low temperatures. J Ne urosurg 1963; 20: 637– 646.

5. Tokuoka S, Aoki H, Higashi K, Takebayashi K. Co oling irrigati on of the cerebral ventricular system. Excerpta Med 1961; 36: 148– 149.

6. Ommaya A, Baldwin M. Extravascular local co oling of the brain in man. J Ne urosurg 1963; 20: 8– 20.

7. Imoto H, Fujii M, Uchiyama J, Fujisawa H, Nakano K, Kunitsugu I et al. Use of a Pelti er chip with newly devised local brain –  co oling system for ne ocortical seizures in the rat. Technical note. J Ne urosurg 2006; 104(1): 150– 156.

8. Tanaka N, Fujii M, Imoto H, Uchiyama J, Nakano K,Nomura S et al. Effective suppressi on of hippocampal seizures in rats by direct hippocampal co oling with a Pelti er chip. J Ne urosurg 2008; 108(4): 791– 797.

9. Schmitt FC, Buchheim K, Mei erkord H, Holtkamp M.Anticonvulsant properti es of hypothermi a in experimental status epilepticus. Ne urobi ol Dis 2006; 23(3): 689– 696.

10. Nakashima K, Todd MM. Effects of hypothermi a on the rate of excitatory amino acid rele ase after ischemic depolarizati on. Stroke 1996; 27(5): 913– 918.

Labels
Paediatric neurology Neurosurgery Neurology
Login
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account