• A&A practice · Feb 2019

    Case Reports

    Intraoperative Generalized Tonic-Clonic Seizure and Consequent Severe Brain Bulge During Functional Motor Cortex Mapping: A Case Report.

    • Ankur Khandelwal, Gyaninder Pal Singh, Akanksha Singh, Shalendra Singh, and Chandrakant Prasad.
    • From the Department of Neuroanaesthesiology and Critical Care.
    • A A Pract. 2019 Feb 1; 12 (3): 66-68.

    AbstractIntraoperative cortical and subcortical bipolar or monopolar mapping is the gold standard for neurosurgical procedures that involve lesions near functional or "eloquent" cortex. However, the classic Penfield stimulation has a higher intraoperative seizure rate than high-frequency short-train stimulation. As a result, high-frequency monopolar stimulation is now the most widely practiced technique. However, seizure-free mapping cannot be guaranteed even with high-frequency stimulation particularly at high current thresholds. We encountered a case of severe generalized tonic-clonic seizure and consequent severe brain bulge in an 8-year-old child during cortical mapping with the high-frequency protocol.

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