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Epilepsy Research and Treatment
Volume 2010 (2010), Article ID 654265, 7 pages
http://dx.doi.org/10.1155/2010/654265
Clinical Study

What Do Changes in Brain Perfusion Induced by Etomidate Suggest about Epilepsy in Human Patients?

1Neurosurgery, The Epilepsy Unit, Hospital Universitario de La Princesa, 28006 Madrid, Spain
2Foundation for Biomedical Research, The Epilepsy Unit, Hospital Universitario de La Princesa, 28006 Madrid, Spain
3School of Medicine, San Pablo-CEU University, Madrid, Spain
4Clinical Neurophysiology, The Epilepsy Unit, Hospital Universitario de La Princesa, 28006 Madrid, Spain
5Nuclear Medicine, The Epilepsy Unit, Hospital Universitario de La Princesa, 28006 Madrid, Spain
6Anesthesiology, The Epilepsy Unit, Hospital Universitario de La Princesa, 28006 Madrid, Spain

Received 21 August 2009; Revised 10 November 2009; Accepted 13 April 2010

Academic Editor: Louis Lemieux

Copyright © 2010 Ivan Herrera-Peco et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Epilepsy is one of the major neurological disorders, affecting roughly 1-2% of the world's population, of which approximately 20–25% of patients are drug resistant. A variety of drugs have been used to activate and identify the epileptic area in patients during presurgical evaluation. We studied the cerebral blood flow (CBF) by single photon-emission computed tomography (SPECT) and bioelectrical brain activity responses to etomidate in 11 patients. Etomidate (0.1 mg/kg) was administered while patients were monitored by video-electroencephalography with foramen ovale electrodes (FOEs). After etomidate administration, a brief period of high-frequency activity was observed, followed by a generalized, high-voltage delta pattern. Increased regional CBF was observed bilaterally in thalamus, putamen, and posterior hippocampus. Besides, the only interhemispheric difference was observed in the posterior hippocampus, where CBF decreased in the epileptic temporal lobe. Activation by etomidate induces a specific and repetitive response in the bioelectrical activity. In addition, CBF changes induced by etomidate may serve as a diagnostic tool in the near future.