Etomidate activates epileptic high frequency oscillations
Etomidate activates epileptic high frequency oscillations
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DOI：
10.1016/j.clinph.2013.07.006
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发表时间：
2014-02-01
影响因子：
4.7
通讯作者：
Stefan, H.
中科院分区：
文献类型：
--
作者：
Rampp, S.;Schmitt, H. J.;Stefan, H.
目的：短效麻醉药依托咪酯已被证明可引起癫痫棘波和罕见的癫痫发作。然而，依托咪酯对癫痫HFO（高频振荡）发生的影响尚不清楚。依托咪酯的HFO诱导作用将允许进一步验证的物质作为一种挑衅措施，在术前评估，以及提供洞察HFO，尖峰和癫痫generation.Methods的共同机制：我们回顾性分析了EEG数据从四名患者谁接受依托咪酯激活侵入性视频脑电图监测与硬膜下条形电极。在原始数据中手动选择尖峰，在带通滤波数据中手动选择HFO（80-250 Hz）。率和空间分布的HFO和尖峰在三个部分进行了比较：立即依托咪酯给药后，以及在慢波睡眠，而awake.Results：率的HFO和尖峰后依托咪酯给药显著增加：总体平均率的尖峰在睡眠期间为9.7/min，清醒时10/min，61.4/min后依托咪酯。平均HFO率在睡眠期间为9.5/min，清醒时为8.3/min，依托咪酯后为24.4/min（p < 0.001，非参数ANOVA）。依托咪酯给药后HFO和棘波的空间分布与癫痫发作区（SOZ）和切除面积（可用时）一致（SOZ：2例患者;切除术：1例患者;无信息：1例患者）。除了假性事件，没有额外的HFO和尖峰灶被视为activation.Conclusions：依托咪酯管理激活尖峰和HFO。空间分布不延伸超出电极显示尖峰和HFO没有依托咪酯，似乎与epileptic network.Significance一致：依托咪酯激活是一个安全的程序，不仅引起癫痫尖峰，但也HFO，这被证明具有高度特异性的SOZ。(C)2013年国际临床神经生理学联合会。由Elsevier爱尔兰有限公司出版。保留所有权利。
Objective: The short acting anesthetic etomidate has been shown to provoke epileptic spikes and rarely seizures. Influence of etomidate on the occurrence of epileptic HFO (high frequency oscillations) however is unknown. An HFO inducing effect of etomidate would allow further validation of the substance as a provocation measure in presurgical evaluation as well as provide insights into the common mechanisms of HFO, spike and seizure generation.Methods: We retrospectively analyzed EEG data from four patients who underwent etomidate activation during invasive video-EEG monitoring with subdural strip electrodes. Spikes were manually selected in raw data, HFO in band pass filtered data (80-250 Hz). Rate and spatial distribution of HFO and spikes in three segments were compared: immediately after etomidate administration, as well as during slow wave sleep and while awake.Results: Rates of HFO and spikes increased significantly after etomidate administration: Overall average rates of spikes were 9.7/min during sleep, 10/min while awake and 61.4/min after etomidate. Average HFO rates were 9.5/min during sleep, 8.3/min while awake and 24.4/min after etomidate (p < 0.001, non-parametric ANOVA). Spatial distributions of HFO and spikes after administration of etomidate were consistent with the seizure onset zone (SOZ) and area of resection when available (SOZ: two patients; resection: one patient; no information: one patient). Except for spurious events, no additional HFO and spike foci were seen with activation.Conclusions: Etomidate administration activates spikes and HFO. Spatial distributions do not extend beyond electrodes showing spikes and HFO without Etomidate and seem consistent with the epileptic network.Significance: Etomidate activation is a safe procedure to provoke not only epileptic spikes but also HFO, which were shown to have a high specificity for the SOZ. (C) 2013 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.