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Screening spreading depolarizations during epilepsy surgery

Edgar Santos1, Daniel Oswaldo Dávila-Rodríguez2, Katia Márquez-Gonzalez2

  • 1Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany.

Acta Neurochirurgica
|March 11, 2019
PubMed
Abstract

Insights

Spreading depolarization (SD) events were not detected during intraoperative recordings in epilepsy surgery. This study investigated the incidence of SDs during operative resections using AC and near-DC recordings.

Area of Science:

  • Neuroscience
  • Epilepsy Research
  • Intracranial Surgery

Background:

  • Spreading depolarization (SD) is a key mechanism in brain injury following energy deprivation.
  • SD has been observed in patients with brain injury, including during intracranial operations.
  • The incidence of SD during operative resections remains unknown.

Purpose of the Study:

  • To determine the incidence and characteristics of spreading depolarization (SD) during intraoperative recordings in epilepsy surgery.
  • To investigate SD events in patients undergoing operative resections for pharmaco-resistant epilepsy.

Main Methods:

  • A retrospective analysis of intraoperative electrocorticography (iECoG) recordings from 69 epilepsy patients.
  • A prospective study utilizing intraoperative near-DC recordings in 20 epilepsy patients.
  • Analysis of a total of 35 hours and 41 minutes of iECoG recordings.

Main Results:

  • Spreading depolarization (SD) events were not detected in either the retrospective or prospective study.
  • No SDs were observed during intraoperative monitoring in any of the analyzed epilepsy surgery cases.

Conclusions:

  • Intraoperative recordings using AC- or near-DC-coupled amplifiers did not detect spreading depolarization (SD) events during epilepsy surgery.
  • The findings suggest SDs may not occur or are not detectable under these specific intraoperative conditions in epilepsy surgery.
Keywords:
Brain injuryEpilepsyEpilepsy surgeryIntraoperative recordingSpreading depolarization

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