gms | German Medical Science

59th Annual Meeting of the German Society of Neurosurgery (DGNC)
3rd Joint Meeting with the Italian Neurosurgical Society (SINch)

German Society of Neurosurgery (DGNC)

1 - 4 June 2008, Würzburg

Article

Send article

Glial tumours and intraoperative seizures: features and usefulness of electrocorticographic monitoring

Meeting Abstract

Search Medline for

  • corresponding author G. Pauletto - Department of Neurology and DPMSC, Azienda Ospedaliero Universitaria S. Maria della Misericordia, Udine, Italy
  • R. Budai - Department of Neurology and DPMSC, Azienda Ospedaliero Universitaria S. Maria della Misericordia, Udine, Italy
  • P. Bergonzi - Department of Neurology and DPMSC, Azienda Ospedaliero Universitaria S. Maria della Misericordia, Udine, Italy
  • M. Skrap - Department of Neurosurgery, Azienda Ospedaliero Universitaria S. Maria della Misericordia, Udine, Italy

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocSO.01.03

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2008/08dgnc003.shtml

Published: May 30, 2008

© 2008 Pauletto et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective: Intraoperative seizures can be induced by surgical procedure as well as mapping techinques: the aim of the present study is to evaluate risk factors for intraoperative seizures particularly with respect to ECoG features and the type of anaesthesia.

Methods: The occurrence of intraoperative seizures was evaluated in a group of 65 patients with glial tumours, located both in the temporal and extra-temporal regions. ECoG was performed before and during resection and reviewed by two different neurophysiologists independently.

Results: Intraoperative seizures occurred in a sub-group of 19 patients, mainly during awake craniotomy. The majority of lesions (13/19) were localized in the motor or pre-motor areas and the related seizures were characterized by sudden onset with fast rhythms, often undistinguished from stimulation artefacts, florid recruiting epileptiform activity and rapid bilateral diffusion. Seizures arising from temporal lobe or insular region were more difficult to detect, because of a lack of motor signs and unusual ECoG features, dominated by fast activity, recruiting slow waves and global deterioration of basic rhythms.

Conclusions: Seizures during surgery are more likely to occur during awake craniotomy, in patients with a previous history of epilepsy and with interictal highly epileptiform activity in the ECoG. Electrocorticographic monitoring, which is not a routine technique in primary brain tumour surgery, provides useful and real-time information regarding changes in brain electrical activity and patients’ behavioural state during the duration of the operation.