Page 203 - MEGIN Book Of Abstracts - 2023

able. The aim of this article is to investigate the fol- BACKGROUND Magnetoencephalography (MEG) plays
lowing hypotheses: (1) Ictal onset zone as localized by a preponderant role in the preoperative assessment of
magnetic source imaging (iMSI) can reliably localize the patients with drug-resistant epilepsy (DRE). However,
EZ in focal epilepsy and (2) this localization is as good the magnetoencephalography of patients with drug-
as that of icEEG. resistant epilepsy can be difficult without sedation
and/or general anesthesia. Our objective is to describe
METHODS. Six original studies and a total of 59 unique our experience with intravenous dexmedetomidine as
patients were included in a meta-analysis. sedation for magnetoencephalography and its effect, if
any, on the ability to recognize epileptic spikes.
RESULTS. Sensitivity and specificity of iMSI based on
surgery outcome were 77% (95% CI 60%-90%) and 75% METHODS In this retrospective study, we reviewed
(95% CI 53%-90%), respectively. Specificity of iMSI was the records of 89 children who presented for Magne-
statistically higher than that of icEEG. There was no toencephalography/electroencephalography (EEG)
significant difference between sensitivity of iMSI and scans between August of 2008 and May of 2015. Data
icEEG. analyzed included demographics and the frequency
of epileptic spikes. Sedated magnetoencephalography
CONCLUSION. The meta-analysis supports that iMSI is recordings were compared to nonsedated video-
an accurate method, achieving similar sensitivity and electroencephalography (vEEG) recordings in the same
higher specificity than icEEG. However, at present the patients to determine the impact of dexmedetomidine.
use of the method is limited by short recording times.
A limitation that might be overcome in the future using RESULTS Spike frequency between magnetoencepha-
technical advances. lography with sedation and video-electroencephalog-
raphy without sedation was compared in 85 patients.
Keywords: epilepsy, epilepsy surgery, ictal, magnetoen- Magnetoencephalography and video-electroenceph-
cephalography, meta-analysis, source localization alography were considered clinically concordant in 80
patients (94.1%) and discordant in 5 patients (5.9%),
Clinical EEG and neuroscience (2020), Vol. 51, No. 6 all with less spikes during Magnetoencephalography.
(32437218) (1 citation) The median (range) bolus dose of dexmedetomidine
was 2 (1-2) mcg/kg. The median (range) infusion rate of
dexmedetomidine was 2 (0.5-4) mcg/kg/h. All patients
Intravenous dexmedetomidine sedation for experienced reductions in heart rate after adminis-
magnetoencephalography: A retrospective study tration of dexmedetomidine; these reductions were
(2020) statistically, but not clinically, significant.

Tewari, Anurag; Mahmoud, Mohamed; Rose, Douglas; CONCLUSIONS Our results suggest that dexmedetomi-
Ding, Lili; Tenney, Jeffrey dine-based protocol provides reliable sedation in chil-
dren undergoing MEG scanning because of the high
Department of Anesthesiology, Cincinnati Children's Hospital success rate, limited interictal artifacts, and minimal
Medical Center, Cincinnati, OH, USA; Department of Pediat- impacts on spike frequency.
rics, University of Cincinnati School of Medicine, Cincinnati,
OH, USA; Division of Biostatistics and Epidemiology, Depart- Keywords: dexmedetomidine, electroencephalography
ment of Pediatrics, Cincinnati Children's Hospital Medical (EEG), intractable epilepsy, magnetoencephalography
Center, Cincinnati, OH, USA; Division of Neurology, Cincinnati (MEG), sedation, spike identification
Children's Hospital Medical Center, Cincinnati, OH, USA
Paediatric anaesthesia (2020), Vol. 30, No. 7 (32436319) (3
citations)

 ontents  Index 182
C