The Anesthetic Considerations of Intraoperative Electrocorticography During Epilepsy Surgery

Chui, Jason MBChB, FANZCA, FHKCA*; Manninen, Pirjo MD, FRCPC*; Valiante, Taufik MD, PhD, FRCS(C); Venkatraghavan, Lashmi MD, FRCA, FRCPC*

Anesthesia & Analgesia:
doi: 10.1213/ANE.0b013e318297390c
Neuroscience In Anesthesiology and Perioperative Medicine: Review Article

Epilepsy surgery is a well-established therapeutic intervention for patients with medically refractory seizures. Success of epilepsy surgery depends on the accurate localization and complete removal of the epileptogenic zone. Despite the advances in presurgical localization modalities, electrocorticography is still used in approximately 60% to 70% of the epilepsy centers in North America to guide surgical resection of the epileptogenic lesion and to assess for completeness of surgery. In this review, we discuss the principles and intraoperative use of electrocorticography, the effect of anesthetic drugs on electrocorticography, and the use of pharmacoactivation for intraoperative localization of epileptogenic zone.

In Brief

Published ahead of print June 18, 2013.

Author Information

From the *Department of Anesthesia and Division of Neurosurgery, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.

Accepted for publication April 3, 2013.

Published ahead of print June 18, 2013.

Funding: No funding.

The authors declare no conflict of interest.

Reprints will not be available from the authors.

Address correspondence to Lashmi Venkatraghavan, MD, FRCA, FRCPC, Department of Anesthesia, Toronto Western Hospital, University Health Network, University of Toronto, 399, Bathurst St., Toronto, Ontario, Canada M5T 2S8. Address e-mail to

© 2013 International Anesthesia Research Society