Seizures lead to elevation of intracranial pressure in children undergoing invasive EEG monitoring

Aash K Shah, Darren Fuerst, Sandeep Sood, Eishi Asano, Judy Ahn-Ewing, Carol Pawlak, Harry T Chugani
Epilepsia 2007, 48 (6): 1097-103

PURPOSE: To study the effects of intracranial subdural grid electrode placement and seizures on intracranial pressure (ICP) in children undergoing invasive EEG monitoring.

METHODS: Sixteen children with pharmacoresistant epilepsy who underwent two-stage epilepsy surgery with subdural grid placement were included in the study. The ICP was recorded at baseline and with each seizure prospectively. A variety of seizure parameters including type of seizure, length of seizure, extent of seizure spread, and number of subdural grid electrodes inserted were analyzed retrospectively and correlated with the change in ICP.

RESULTS: A total of 48 seizures in 16 children were studied. The mean baseline ICP correlated positively with age of the child. Generalized tonic-clonic seizures were associated with the highest rise in ICP. Similarly, ICP rise was associated with seizures involving more electrodes indicating a larger area of brain participating in the seizure.

CONCLUSION: Seizures in general and generalized tonic-clonic seizures, in particular, increase ICP temporarily in patients who are undergoing invasive EEG monitoring with subdural grids.

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