Awake craniotomy without sedation in treatment of patients with lesional epilepsy

Surgical Neurology International
A R SitnikovL P Mishnyakova

Abstract

The use of awake craniotomy for surgical treatment of epilepsy was applied in surgery of convexital tumors, arteriovenous malformations, some superficial aneurysms, and stereotactic neurosurgery. The aim of this study was to show the advantages of awake craniotomy without sedation, accompanied by intraoperative neurophysiological monitoring in patients with symptomatic epilepsy. This article describes the results of surgical treatment in 41 patients with various pathologies; 31 among them suffered from epilepsy. Most frequently, the pathological foci were located in frontal and parietal lobes nearby eloquent brain areas. Irrespective of damage location, simple partial and complex partial seizures were seen almost with the same frequency. Intraoperative mapping of eloquent cortical areas and subcortical tracts without sedation resulted in total resection of pathological area in 75% of cases with low rate of permanent neurological deficit (two patients). Minor perioperative complications, including the decrease in blood pressure in six patients and intraoperative convulsions in two patients, were handled and did not led to operation termination or anesthesia conversion. Excellent seizures control (Engel 1) was achieved in 80% of ...Continue Reading

Citations

Jun 22, 2021·The Egyptian Journal of Neurology, Psychiatry and Neurosurgery·Esam AbdelhameedHytham Ibrahim Shokry Elatrozy

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BETA
surgical resections
sedation

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MAC
SAS

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