Balakrishnan Guruswamy, Grover Kavita M, Mason Karen, Smith Brien, Barkley Gregory L, Tepley Norman, Bowyer Susan M
Department of Anesthesiology, Henry Ford Medical Group, Detroit, Michigan, USA.
Anesth Analg. 2007 Jun;104(6):1493-7, table of contents. doi: 10.1213/01.ane.0000264084.12323.43.
A magnetoencephalography (MEG) study requires the patient to lie still for a prolonged period of time. In children and uncooperative adults with epilepsy, general anesthesia or sedation may be required to insure a good quality study. As general anesthetics have anticonvulsant and proconvulsant properties, we investigated whether the use of anesthesia reduced the successful detection of interictal epilepsy activity.
MEG testing was performed on 41 epilepsy patients (10 women, 31 men; 1-48 yr) while anesthetized. To determine the impact of anesthesia on the identification of epileptiform activity, the anesthesia group of patients was compared with all other patients with epilepsy who were recorded in our laboratory without anesthesia, as well as with a subgroup of children with epilepsy who were able to be recorded without the need for anesthesia.
Propofol was used in 38 patients, etomidate in two, and one received sevoflurane. Twenty-nine (71%) were found to have interictal epileptiform activity in their MEG results. The percentage of MEG studies with a positive yield for interictal epileptiform activity is comparable with the percentage (63%) found in the patients with epilepsy undergoing MEG without anesthesia. In the 38 children younger than 18 yr, 28 (74%) had interictal epileptiform activity compared with 80% done without anesthesia.
We conclude that levels of anesthesia needed to provide unconsciousness and immobility during MEG studies do not significantly alter the likelihood of recording interictal epileptiform spike activity with MEG.
脑磁图（MEG）研究要求患者长时间保持静止。对于患有癫痫的儿童和不配合的成年人，可能需要全身麻醉或镇静以确保高质量的研究。由于全身麻醉药具有抗惊厥和促惊厥特性，我们研究了麻醉的使用是否会降低发作间期癫痫活动的成功检测率。
对41例癫痫患者（10名女性，31名男性；年龄1 - 48岁）在麻醉状态下进行MEG测试。为了确定麻醉对癫痫样活动识别的影响，将麻醉组患者与我们实验室记录的所有其他未麻醉的癫痫患者以及一组无需麻醉即可记录的癫痫儿童亚组进行比较。
38例患者使用丙泊酚，2例使用依托咪酯，1例使用七氟醚。在他们的MEG结果中，29例（71%）被发现有发作间期癫痫样活动。MEG研究中发作间期癫痫样活动阳性率与未麻醉进行MEG检查的癫痫患者中发现的阳性率（63%）相当。在38名18岁以下的儿童中，28例（74%）有发作间期癫痫样活动，而未麻醉时的阳性率为80%。
我们得出结论，在MEG研究期间提供意识丧失和不动所需的麻醉水平不会显著改变通过MEG记录发作间期癫痫样棘波活动的可能性。
