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Inicio Revista Española de Anestesiología y Reanimación (English Edition) Density spectral array of BIS VISTA™ monitoring system in a functional hemisph...
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Vol. 65. Issue 8.
Pages 473-476 (October 2018)
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Vol. 65. Issue 8.
Pages 473-476 (October 2018)
Case report
DOI: 10.1016/j.redare.2018.07.001
Density spectral array of BIS VISTA™ monitoring system in a functional hemispherectomy
Monitorización con espectrograma del sistema de monitorización BIS VISTA™ en una hemisferectomía funcional
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C. Luis
Corresponding author
61307@parcdesalutmar.cat

Corresponding author.
, E. Vilà, L. Moltó, A. Pardo, J.L. Fernández Candila, S. Pacreu
Departamento de Anestesiología y Reanimación, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
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Abstract

We present the case of an adult patient with drug-resistant epilepsy caused by extensive inflammation in the right cerebral hemisphere. She was scheduled to undergo right functional hemispherectomy, which is common in pediatric surgery, but about which few studies have been published with respect to adult patients. During the intraoperative period, the density spectral array of the bilateral bispectral index (BIS) VISTA™ monitoring system was used. We observed a power increase in low frequency (0.1–4Hz) and alpha bands (8–12Hz) in the right hemisphere, where the epileptogenic focus was. During disconnection from the frontal lobe, there was a marked decrease of power in low frequency and alpha bands on the right side, with no changes during disconnection from other areas of the brain. We think that further studies are needed to determine whether the density spectral array can be a useful tool for monitoring the effectiveness of functional hemispherectomy.

Keywords:
Density spectral array
Bilateral bispectral index
Functional hemispherectomy
Resumen

Presentamos el caso de una paciente adulta con epilepsia farmacorresistente secundaria a una inflamación extensa del hemisferio cerebral derecho, que fue programada para realizársele una hemisferectomía funcional. Se trata de una cirugía habitual en pediatría, pero con pocas publicaciones en pacientes adultos. Durante el intraoperatorio se utilizó el espectrograma perteneciente al sistema de monitorización VISTA™ del índice biespectral bilateral (BIS). Se objetivó un aumento de potencia en las bandas de baja frecuencia (0,1-4Hz) y en las bandas alfa (8-12Hz) del hemisferio cerebral derecho, donde se encontraba el foco epileptógeno. Durante la desconexión del lóbulo frontal se observó una marcada disminución de potencia en dichas bandas, sin objetivarse cambios durante la desconexión de las otras áreas cerebrales. Pensamos que se necesitan más estudios para saber si el espectrograma puede ser una herramienta útil para monitorizar la efectividad de la hemisferectomía funcional.

Palabras clave:
Espectrograma
Índice biespectral bilateral
Hemisferectomía funcional

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