Focal Cooling Suppresses Spontaneous Epileptiform Activity without Changing the Cortical Motor Threshold

Authors


Address correspondence and reprint requests to Dr. K.M. Karkar at Department of Neurology, University of California at San Francisco, San Francisco, CA, U.S.A. E-mail: karkark@itsa.ucsf.edu

Abstract

Summary:  Purpose: Focal cerebral cooling has been shown to reduce epileptiform activity in animals. There are, however, few reports of this phenomenon in humans.

Methods: Electrocorticography was performed before resection of a right frontal tumor in a patient with partial seizures. Cold saline was applied to the interictal spike focus, and its effect on the epileptiform discharges was observed.

Results: Application of cold saline to the spike focus resulted in a transient, complete cessation of spiking. This effect was reproduced with a second application of cold saline. The motor threshold for electrical stimulation remained unchanged during the application of saline.

Conclusions: In this patient with tumor-related epilepsy, focal cooling of the cortex reproducibly abolished interictal epileptiform discharges without changing the motor threshold to electrical stimulation.

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