Somatosensory-evoked fields on magnetoencephalography for epilepsy infants younger than 4 years with total intravenous anesthesia

Clin Neurophysiol. 2008 Jun;119(6):1328-34. doi: 10.1016/j.clinph.2008.02.018. Epub 2008 Apr 10.

Abstract

Objective: Patients must remain immobile for magnetoencephalography (MEG) and MRI recordings to allow precise localization of brain function for pre-surgical functional mapping. In young children with epilepsy, this is accomplished with recordings during sleep or with anesthesia. This paper demonstrates that MEG can detect, characterize and localize somatosensory-evoked fields (SEF) in infants younger than 4 years of age with or without total intravenous anesthesia (TIVA).

Methods: We investigated the latency, amplitude, residual error (RE) and location of the N20m of the SEF in 26 infants (mean age=2.6 years). Seventeen patients underwent TIVA and 9 patients were tested while asleep, without TIVA.

Results: MEG detected 44 reliable SEFs (77%) in 52 median nerve stimulations. We found 27 reliable SEFs (79%) with TIVA and 13 reliable SEFs (72%) without TIVA. TIVA effects included longer latencies (p<0.001) and lower RE (p<0.05) compared to those without TIVA. Older patients and larger head circumferences also showed significantly shorter latencies (p<0.01).

Conclusions: TIVA resulted in reliable SEFs with lower RE and longer latencies.

Significance: MEG can detect reliable SEFs in infants younger than 4 years old. When infants require TIVA for MEG and MRI acquisition, SEFs can still be reliably observed.

Publication types

  • Clinical Trial

MeSH terms

  • Analysis of Variance
  • Anesthesia / methods*
  • Anesthesia, Intravenous / methods*
  • Brain Mapping*
  • Chi-Square Distribution
  • Child, Preschool
  • Electric Stimulation / methods
  • Epilepsy / diagnosis*
  • Epilepsy / physiopathology*
  • Evoked Potentials, Somatosensory / drug effects
  • Evoked Potentials, Somatosensory / physiology*
  • Female
  • Humans
  • Infant
  • Magnetoencephalography
  • Male
  • Median Nerve / physiopathology
  • Median Nerve / radiation effects
  • Reaction Time