Transient facial palsy in sphenoidal electrode placement

Epilepsia
J IriarteA M Kanner

Abstract

Sphenoidal electrode (SE) insertion can cause pain, for which local anesthesia with lidocaine or intravenous administration of fentanyl has been advocated by different epilepsy treatment centers. Transient facial palsies have been observed after SE insertion. Their frequency of occurrence, distribution, and duration have not been well characterized, however. We hypothesized that this complication is due to the effect of local anesthesia on the peripheral branches of the seventh cranial nerve. To test this hypothesis, we compared the incidence and characteristics of facial palsy during SE insertions performed with either local anesthesia or after intravenous fentanyl administration. We performed a retrospective study in two patient groups. Group A consisted of 25 patients aged 28 +/- 8.2 years who underwent a prolonged video-EEG (VEEG) monitoring study with SE after subcutaneous infusion of 1% lidocaine in the insertion area. Group B included 25 patients aged 30.1 +/- 8.9 years whose SE were inserted after intravenous administration of 100-200 micrograms fentanyl. Blood pressure (BP) was monitored every 3-5 min throughout the procedure. Five patients (20%) from group A had a transient facial palsy; in 4, it was complete and in 1...Continue Reading

References

May 1, 1992·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·L SeptienR Dumas
Sep 1, 1990·Epilepsia·E WyllieA Kanner
Jan 1, 1986·Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society·D W KingB B Gallagher
Jan 1, 1986·Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society·M R Sperling, J Engel
Jan 1, 1996·Epilepsia·C W Bazil, T S Walczak

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Citations

Jun 6, 2002·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·Scott MintzerJerome Engel
Jan 1, 2004·Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society·Warren T Blume
Apr 17, 2009·AJNR. American Journal of Neuroradiology·D V La BargeE A Stevens
Jan 1, 2004·Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society·Michael R Sperling, Lia Guina

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