Methohexital (Brevital) effect on electrocorticogram may be misleading. 1990

M E Fiol, and F Torres, and J R Gates, and R Maxwell
MINCEP Epilepsy Care, P.A., Minneapolis, Minnesota 55416.

Intravenous (i.v.) methohexital (MTH, Brevital) was found to have an effect on the intraoperative electrocorticogram (ECOG) of 63 patients who had temporal lobectomies performed under general anesthesia for intractable complex partial seizures. In the preresection ECOG, MTH increased the frequency of spikes in 78%, the area of cortical spiking in 30% and induced seemingly "new" spike foci in 43%. Similar although less dramatic changes occurred in the final (i.e., postresection) ECOG. Whether these changes induced by MTH, specifically the new spike foci, are significant was assessed by correlating surgical results with the presence of "residual spikes" (i.e., after all resections, not spontaneously occurring but activated by MTH). Surprisingly, nine patients with residual "MTH-spikes" did not have any postoperative seizures whereas two had some. This raises the question of whether MTH effects are significant overall. Caution is advised in the use of MTH in intraoperative assessment of interictal spike fields, especially when new spike foci are activated. Further study of the possibility of false activation, with a larger series, is advised.

UI MeSH Term Description Entries
D008297 Male Males
D008723 Methohexital An intravenous anesthetic with a short duration of action that may be used for induction of anesthesia. Methohexitone,Brevimytal Natrium,Brevital,Brietal,Brietal-Sodium,Methohexital Sodium,Methohexital, Monosodium Salt,Brietal Sodium,Monosodium Salt Methohexital,Natrium, Brevimytal,Sodium, Methohexital
D011184 Postoperative Period The period following a surgical operation. Period, Postoperative,Periods, Postoperative,Postoperative Periods
D002540 Cerebral Cortex The thin layer of GRAY MATTER on the surface of the CEREBRAL HEMISPHERES that develops from the TELENCEPHALON and folds into gyri and sulci. It reaches its highest development in humans and is responsible for intellectual faculties and higher mental functions. Allocortex,Archipallium,Cortex Cerebri,Cortical Plate,Paleocortex,Periallocortex,Allocortices,Archipalliums,Cerebral Cortices,Cortex Cerebrus,Cortex, Cerebral,Cortical Plates,Paleocortices,Periallocortices,Plate, Cortical
D004569 Electroencephalography Recording of electric currents developed in the brain by means of electrodes applied to the scalp, to the surface of the brain, or placed within the substance of the brain. EEG,Electroencephalogram,Electroencephalograms
D004833 Epilepsy, Temporal Lobe A localization-related (focal) form of epilepsy characterized by recurrent seizures that arise from foci within the TEMPORAL LOBE, most commonly from its mesial aspect. A wide variety of psychic phenomena may be associated, including illusions, hallucinations, dyscognitive states, and affective experiences. The majority of complex partial seizures (see EPILEPSY, COMPLEX PARTIAL) originate from the temporal lobes. Temporal lobe seizures may be classified by etiology as cryptogenic, familial, or symptomatic. (From Adams et al., Principles of Neurology, 6th ed, p321). Epilepsy, Benign Psychomotor, Childhood,Benign Psychomotor Epilepsy, Childhood,Childhood Benign Psychomotor Epilepsy,Epilepsy, Lateral Temporal,Epilepsy, Uncinate,Epilepsies, Lateral Temporal,Epilepsies, Temporal Lobe,Epilepsies, Uncinate,Lateral Temporal Epilepsies,Lateral Temporal Epilepsy,Temporal Lobe Epilepsies,Temporal Lobe Epilepsy,Uncinate Epilepsies,Uncinate Epilepsy
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013702 Temporal Lobe Lower lateral part of the cerebral hemisphere responsible for auditory, olfactory, and semantic processing. It is located inferior to the lateral fissure and anterior to the OCCIPITAL LOBE. Anterior Temporal Lobe,Brodmann Area 20,Brodmann Area 21,Brodmann Area 22,Brodmann Area 37,Brodmann Area 38,Brodmann Area 52,Brodmann's Area 20,Brodmann's Area 21,Brodmann's Area 22,Brodmann's Area 37,Brodmann's Area 38,Brodmann's Area 52,Inferior Temporal Gyrus,Middle Temporal Gyrus,Parainsular Area,Fusiform Gyrus,Gyrus Fusiformis,Gyrus Temporalis Superior,Inferior Horn of Lateral Ventricle,Inferior Horn of the Lateral Ventricle,Lateral Occipito-Temporal Gyrus,Lateral Occipitotemporal Gyrus,Occipitotemporal Gyrus,Planum Polare,Superior Temporal Gyrus,Temporal Cortex,Temporal Gyrus,Temporal Horn,Temporal Horn of the Lateral Ventricle,Temporal Operculum,Temporal Region,Temporal Sulcus,Anterior Temporal Lobes,Area 20, Brodmann,Area 20, Brodmann's,Area 21, Brodmann,Area 21, Brodmann's,Area 22, Brodmann,Area 22, Brodmann's,Area 37, Brodmann,Area 37, Brodmann's,Area 38, Brodmann,Area 38, Brodmann's,Area 52, Brodmann,Area 52, Brodmann's,Area, Parainsular,Areas, Parainsular,Brodmanns Area 20,Brodmanns Area 21,Brodmanns Area 22,Brodmanns Area 37,Brodmanns Area 38,Brodmanns Area 52,Cortex, Temporal,Gyrus, Fusiform,Gyrus, Inferior Temporal,Gyrus, Lateral Occipito-Temporal,Gyrus, Lateral Occipitotemporal,Gyrus, Middle Temporal,Gyrus, Occipitotemporal,Gyrus, Superior Temporal,Gyrus, Temporal,Horn, Temporal,Lateral Occipito Temporal Gyrus,Lobe, Anterior Temporal,Lobe, Temporal,Occipito-Temporal Gyrus, Lateral,Occipitotemporal Gyrus, Lateral,Operculum, Temporal,Parainsular Areas,Region, Temporal,Sulcus, Temporal,Temporal Cortices,Temporal Gyrus, Inferior,Temporal Gyrus, Middle,Temporal Gyrus, Superior,Temporal Horns,Temporal Lobe, Anterior,Temporal Lobes,Temporal Lobes, Anterior,Temporal Regions

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