• Sadahiro Nomura, Masami Fujii, Takao Inoue, Yeting He, Yuichi Maruta, Hiroyasu Koizumi, Eiichi Suehiro, Hirochika Imoto, Hideyuki Ishihara, Fumiaki Oka, Mishiya Matsumoto, Yuji Owada, Takeshi Yamakawa, and Michiyasu Suzuki.
• Department of Neurosurgery, Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan.
• Epilepsia. 2014 May 1;55(5):770-6.

ObjectiveRecently, focal brain cooling (FBC) was proposed as a method for treating refractory epilepsy. However, the precise influence of cooling on the molecular basis of epilepsy has not been elucidated. Thus the aim of this study was to assess the effect of FBC on glutamate (Glu) concentration, cerebral blood flow (CBF), and glucose metabolism in patients with intractable epilepsy.MethodsNine patients underwent FBC at 15°C for 30 min prior to cortical resection (n = 6) or hippocampectomy (n = 3). Measurement of metabolites and CBF, as well as electrocorticography (ECoG), was performed.ResultsEpileptic discharge (ED), as observed by ECoG, disappeared in the cooling period and reappeared in the rewarming period. Glu concentrations were high during the precooling period and were reduced to 51.2% during the cooling period (p = 0.025). Glycerol levels showed a similar decrease (p = 0.028). Lactate concentration was high during the precooling period and was reduced during the cooling period (21.3% decrease; p = 0.005). Glucose and pyruvate levels were maintained throughout the procedure. Changes in CBF were parallel to those observed by ECoG.SignificanceFBC reduced EDs and concentrations of Glu and glycerol. This demonstrates the neuroprotective effect of FBC. Our findings confirm that FBC is a reasonable and optimal treatment option for patients with intractable epilepsy.Wiley Periodicals, Inc. © 2014 International League Against Epilepsy.

46 keywords...

hide…