%0 Journal Article
%T Possible Cortical Spreading Depression Recorded Intraoperatively Following a Generalized Seizure: Illustrative Case
%A Greg Schaublin
%A Romina Shirka
%A Nabil Azar
%A Callan Broderick
%A Jayson Neil
%A George R. Lee
%A Kiara Ebinger
%J Neuroscience & Medicine
%P 119-128
%@ 2158-2947
%D 2024
%I Scientific Research Publishing
%R 10.4236/nm.2024.153010
%X <b>Background:</b> We present a compelling case fitting the phenomenon of cortical spreading depression detected by intraoperative neurophysiological monitoring (IONM) following an intraoperative seizure during a craniotomy for revascularization. Cortical spreading depression (CSD, also called cortical spreading depolarization) is a pathophysiological phenomenon whereby a wave of depolarization is thought to propagate across the cerebral cortex, creating a brief period of relative neuronal inactivity. The relationship between CSD and seizures is unclear, although some literature has made a correlation between seizures and a cortical environment conducive to CSD. <b>M</b><b>e</b><b>thods:</b> Intraoperative somatosensory evoked potentials (SSEPs) and electroencephalography (EEG) were monitored continuously during the craniotomy procedure utilizing standard montages. Electrophysiological data from pre-ictal, ictal, and post-ictal periods were recorded. <b>Results:</b> During the procedure, intraoperative EEG captured a generalized seizure followed by a stepwise decrease in somatosensory evoked potential cortical amplitudes, compelling for the phenomenon of CSD. The subsequent partial recovery of neuronal function was also captured electrophysiologically. <b>Discussion:</b> While CSD is considered controversial in some aspects, intraoperative neurophysiological monitoring allowed for the unique analysis of a case demonstrating a CSD-like phenomenon. To our knowledge, this is the first published example of this phenomenon in which intraoperative neurophysiological monitoring captured a seizure, along with a stepwise subsequent reduction in SSEP cortical amplitudes not explained by other variables.
%K Cortical Spreading Depression
%K Electroencephalography
%K Intraoperative Neurophysiological Monitoring
%K Seizure
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=134432