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Chapter-23 Monitoring During Epilepsy Surgery and Awake Craniotomy

BOOK TITLE: Monitoring in Anesthesia and Critical Care

Author
1. Kulkarni Dilip K
2. Moningi Srilata
ISBN
9789352700431
DOI
10.5005/jp/books/18044_24
Edition
1/e
Publishing Year
2018
Pages
10
Author Affiliations
1. Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India
2. Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India
Chapter keywords
Epilepsy surgery, asleep–awake–asleep technique, asleep-awake technique, monitored anesthesia care, MAC, motor evoked potential, hemodynamic alteration, obstructive sleep apnea, OSA

Abstract

This chapter discusses the monitoring during epilepsy surgery and awake craniotomy. The goal of epilepsy surgery is to identify an abnormal area of cortex from which the seizures originate and remove it without causing any significant functional impairment. Penfield first used awake craniotomy with intraoperative mapping in epilepsy surgery. This technique provides the surgeon with real-time localization of functional regions in the brain and allows preservation of these regions by resulting in maximal and safe resection. This avoids many of the routinely used anesthetic agents which are shown to interfere with neurophysiological monitoring. Asleep–awake–asleep technique, asleep-awake technique, and monitored anesthesia care are different types of techniques of anesthesia for epilepsy surgery. Monitoring during epilepsy surgery consists of the monitoring modalities used for general anesthesia and also the special neurophysiological modalities, which needs modification of the technique of anesthesia.

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