EFFICACY OF STEROID FOR CEREBRAL EDEMA AND SEIZURES DURING SUBDURAL GRID EEG MONITORING IN CHILDREN
Abstract number :
2.455
Submission category :
Year :
2003
Submission ID :
2511
Source :
www.aesnet.org
Presentation date :
12/6/2003 12:00:00 AM
Published date :
Dec 1, 2003, 06:00 AM
Authors :
Takashi Araki, Hiroshi Otsubo, Yuko Makino, Ayako Ochi, Koji Iida, Shelly K. Weiss, Sylvester H. Chuang, James T. Rutka, Carter Snead III Neurosurgery, The Hospital for Sick Children, Toronto, ON, Canada; Neurology, The Hospital for Sick Children, Toronto
We evaluated how steroid influences cerebral edema and seizures in subdural grid EEG (SGEEG) monitoring in children with intractable epilepsy.
We retrospectively reviewed hospital charts of 37 patients with intractable epilepsy, who underwent SGEEG monitoring at The Hospital for Sick Children. To identify the efficacy of steroid for cerebral edema and seizures, we classified all patients into two groups; Group A includes patients who were given dexamethasone; Group B includes patients who were not given dexamethasone. We investigated CT findings, seizure profiles, neurological and physical findings during SGEEG.
Group A had 23 patients and Group B had14 patients. Seven of the 37 patients (19%) presented cerebral edema on CT. The cerebral edema occurred two in Group A (9%) less than 7 in Group B (50%) with a statistical significance (p[lt]0.05). Monitoring days to capture enough number of seizures for epilepsy surgery, were longer in Group A (1 to 6 days, mean 3days) than those in Group B (1 to 3 days, mean 2 days) with a statistical significance (p[lt]0.05). The total number of captured seizures in both groups equally ranged from 2 to 48 (mean 19) in Group A and 5 to 70 (mean 18) in Group B. There was no correlation between cerebral edema and the number of electrodes on grid, the number of arrays of subdural grids, strips and depth electrodes, the total days of SGEEG monitoring, the side of subdural grid, and age.
The steroid treatment for pediatric patients during SGEEG monitoring probably has an efficacy to protect the cerebral edema. Although steroid decreased the frequency of seizures, the steroid treatment is conciliated for preventing critical cerebral edema by subdural grid placement.