Abstract
Neurosurgical treatment of pediatric patients harbors specific considerations. Neocortical resective surgery is unique in the challenges of operating in the proximity of eloquent cortex, and in some diseases, such as focal intractable epilepsy, an appreciable fraction of neocortical resections are destined to be in the pediatric population. Using nTMS for motor and language mapping is becoming increasingly valued in pediatric presurgical planning. The nTMS technique has demonstrable utility for obtaining the information needed for localization of motor and language function in children, with minimal associated health risks and very little difficulty on behalf of the operator.
This chapter outlines the special considerations for nTMS in pediatric patients, including modifications to equipment setups, stimulation intensities, and potential influence of antiepileptic medications. It moreover outlines the differences of nTMS compared to other functional mapping techniques in the pediatric population and provides practical information on how to work with children of any age in order to obtain optimal mapping results.
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References
Bahn MM, et al. Localization of language cortices by functional MR imaging compared with intracarotid amobarbital hemispheric sedation. AJR. American journal of roentgenology 1997;169(2):575–79.
Beers CA, Federico P. Functional MRI applications in epilepsy surgery. Can J Neurol Sci 2012;39(3):271–85.
Berg AT, et al. Age at onset of epilepsy, pharmacoresistance, and cognitive outcomes a prospective cohort study. Neurology. 2012;79(13):1384–91.
Branco DM, et al. Functional MRI of memory in the hippocampus: Laterality indices may be more meaningful if calculated from whole voxel distributions. Neuroimage 2006;32(2):592–602.
Clusmann H, et al. Analysis of different types of resection for pediatric patients with temporal lobe epilepsy. Neurosurgery. 2004;54(4):847–60.
Dorfmüller G, et al. Outcome of surgery in children with focal cortical dysplasia younger than 5 years explored by stereo-electroencephalography. Childs Nerv Syst. 2014;30(11):1875–83.
Duchowny MS. Surgery for intractable epilepsy: issues and outcome. Pediatrics. 1989;84(5):886–94.
Eyre JA, et al. Evidence of activity-dependent withdrawal of corticospinal projections during human development. Neurology. 2001;57(9):1543–54.
Garrett MC, Nader P, Linda ML. Use of language mapping to aid in resection of gliomas in eloquent brain regions. Neurosurgery clinics of North America 2012;23(3):497–506.
Giulioni M, et al. Seizure outcome of epilepsy surgery in focal epilepsies associated with temporomesial glioneuronal tumors: lesionectomy compared with tailored resection: Clinical article. J Neurosurg. 2009;111(6):1275–82.
Griessenauer CJ, Salam S, Hendrix P, et al. Hemispherectomy for treatment of refractory epilepsy in the pediatric age group: a systematic review. J Neurosurg Pediatr. 2015;15:34–44.
Hertz-Pannier L, et al. Noninvasive assessment of language dominance in children and adolescents with functional MRI A preliminary study. Neurology. 1997;48(4):1003–12.
Holmes GL. Intractable epilepsy in children. Epilepsia 1996;37(s3):14–27.
Kaye HL, et al. Neurophysiological evidence of preserved connectivity in tuber tissue. Epilepsy Behav Case Rep. 2016.
Kaye HL, Gersner R, Pascual-Leone A, Boes A, Peters JM, Rotenberg A. Motor mapping by transcranial magnetic stimulation reveals a pathologically preserved immature motor lateralization in patients with intractable focal epilepsy. In: American academy of neurology annual meeting. 2017.
Koh TH, Eyre JA. Maturation of corticospinal tracts assessed by electromagnetic stimulation of the motor cortex. Arch Dis Child. 1988;63(11):1347–52.
Kwan A, Ng WH, Otsubo H, Ochi A, Snead OC III, Tamber MS, et al. Hemispherectomy for the control of intractable epilepsy in childhood: comparison of 2 surgical techniques in a single institution. Neurosurgery. 2010;67(2 Suppl Operative):429–36.
Lin K-L, Pascual-Leone A. Transcranial magnetic stimulation and its applications in children. Chang Gung Med J. 2002;25(7):424–36.
Loddenkemper T, Harold HM, and Gabriel M. Complications during the Wada test. Epilepsy & Behavior 2008;13(3):551–53.
Loring DW, Meador KJ, Lee GP, King DW. Amobarbital effects and lateralized brain function: the Wada test. New York: Springer-Verlag; 1992.
Loring DW, Meador KJ, Lee GP, et al. Wada memory performance predicts seizure outcome following anterior temporal lobectomy. Neurology. 1994;44:2322–4.
Macedoni-Lukšič M, Jereb B, Todorovski L. Long-term sequelae in children treated for brain tumors: impairments, disability, and handicap. Pediatr Hematol Oncol. 2003;20(2):89–101.
Paulus W, et al. State of the art: pharmacologic effects on cortical excitability measures tested by transcranial magnetic stimulation. Brain stimulation 2008;1(3):151–63.
Perry MS, Duchowny M. Surgical management of intractable childhood epilepsy: curative and palliative procedures. Semin Pediatr Neurol. 2011;18(3):195–202.
Pohlmann-Eden B, et al. The first seizure and its management in adults and children. BMJ. 2006;332(7537):339.
Price CJ, Crinion J, Friston KJ. Design and analysis of fMRI studies with neurologically impaired patients. J Magn Reson Imaging. 2006;23(6):816–26.
Saneto RP, Elaine W. Surgically treatable epilepsy syndromes in infancy and childhood. Epilepsy Surgery: Principles and Controversies. CRC Press, 2005;121–41.
Souweidane MM, et al. Brain mapping in sedated infants and young children with passive-functional magnetic resonance imaging. Pediatr Neurosurg. 1999;30(2):86–92.
Spencer DC, Morrell MJ, Risinger MW. The role of the intracarotid amobarbital procedure in evaluation of patients for epilepsy surgery. Epilepsia. 2000;41(3):320–5.
Sperling MR, Saykin AJ, Glosser G, et al. Predictors of outcome after anterior temporal lobectomy: the intracarotid amobarbital test. Neurology. 1994;44:2325–30.
Szaflarski JP, et al. Practice guideline summary: use of fMRI in the presurgical evaluation of patients with epilepsy: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology. 2017;88(4):395–402.
Weiner HL, et al. Epilepsy surgery for children with tuberous sclerosis complex. J Child Neurol. 2004;19(9):687–9.
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Kaye, H.L., Rotenberg, A. (2017). nTMS in Pediatrics: Special Issues and Solutions. In: M. Krieg, S. (eds) Navigated Transcranial Magnetic Stimulation in Neurosurgery. Springer, Cham. https://doi.org/10.1007/978-3-319-54918-7_12
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DOI: https://doi.org/10.1007/978-3-319-54918-7_12
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