Detection of epileptiform discharges by patient state index and density spectral array during anesthetic emergence after resection of hemispheric brain tumor. Case report

Abstract

Background: Processed electroencephalogram (EEGp) plays a crucial role in anesthesia as a quantitative and automated method for assessing anesthetic depth. It utilizes mathematical algorithms to furnish objective measures, offering an intuitive interface for anesthesiologists lacking specialized neurophysiology training. Among the array of visual graphical analyses, the Density Spectral Array (DSA) stands out as particularly promising. DSA furnishes a comprehensive and visual depiction of the patient's brain activity, aiding anesthesiologists in maintaining optimal anesthetic depth during surgical procedures Conclusion: This report underscores the potential of analyzing Case report: A 51-year-old male with a medical history of neurofibromatosis type 2 and a frontal hemispheric brain tumor underwent resection in the operating room under total intravenous anesthesia. Anesthetic depth was monitored utilizing SedLine® Patient Status Index (PSi). The resection proceeded uneventfully; however, upon extubation, EEG processing revealed epileptiform discharges concurrent with tonic-clonic movement of the right hand electroencephalogram waveforms alongside the latest SedLine-derived Density Spectral Array to confirm the presence of partial epileptic seizures during the immediate post-extubation and postoperative phases following brain tumor resection. Employing advanced monitoring techniques like Density Spectral Array aids in early detection of neurological complications, facilitating timely intervention and potentially enhancing patient outcomes during the critical postoperative period.