Anestezija u bolesnika s epilepsijom

master's thesis

• Title (english): Anesthesia in patients with epilepsy
• Author: Filip Radevski
• Mentor: Ante Sekulić (mentor)
• Committee member: Slobodan Mihaljević (predsjednik povjerenstva)
• Committee member: Dinko Tonković (član povjerenstva)
• Committee member: Ante Sekulić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Anaesthesiology, Resuscitation and Intensive Care in Surgical Specialities); Zagreb
• Defense date and country: 2021-07-16, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Anesthesiology and Reanimatology

Abstract

Epilepsija je neurološki poremećaj karakteriziran predispozicijom za nastanak abnormalnih ekscesivnih i sinkronih neuronalnih izbijanja koja vode do epileptičkih napadaja koji mogu biti značajno opterećenje za bolesnike, a potencijalno su i životno ugrožavajući. Epilepsija je česta bolest s incidencijom od 50 slučaja na 100.000 osoba po godini u razvijenim zemljama i prevalencijom od 4 do 10 slučaja na 1000 osoba po godini. Lijekovi korišteni u anesteziji često imaju utjecaj, bilo pozitivan ili negativan, na epilepsiju i epileptičke napadaje. Važno je da je anesteziološki pristup kirurškom bolesniku s epilepsijom prilagođen njegovoj bolesti kako bi se izbjegli neželjeni događaji poput epileptičkih napadaja i epileptičkog statusa, bilo za vrijeme ili neposredno nakon operacije. Pri kirurškom liječenju epilepsije je širok izbor kirurških i anestezioloških tehnika koje trebaju biti pažljivo odabrane za pojedinačnog bolesnika i njegove potrebe. U bolesnika s epilepsijom kod kojih neinvazivni EEG i neuroradiološke slikovne metode poput MR-a ili CT-a nisu dovoljne za lokalizaciju epileptogenih lezija, ili kod kojih se lezija nalazi blizu ključnih područja mozga, pristupa se budnoj kraniotomiji uz korištenje invazivne elektrokortikografije ili kortikalnog mapiranja prilikom kojih je ključno prilagoditi utjecaj anestezije na neurofiziološke funkcije kako epileptiformna aktivnost ne bi bila suprimirana što bi onemogućilo izvođenje zahvata.

Abstract (english)

Epilepsy is a neurological disorder characterized by a predisposition for the occurrence of abnormal excessive and synchronous neuronal discharges that lead to epileptic seizures, which can be a significant burden for the patient, and can be potentially life endangering. Epilepsy is a common disease with an incidence of 50 cases per 100,000 people per year in developed countries and a prevalence of 4 to 10 cases per 1000 people per year. Drugs used in anesthesia often have an effect, whether positive or negative, on epilepsy and epileptic seizures. It is important that the anesthesiological approach to a surgical patient with epilepsy is adapted to his condition in order to avoid undesirable events such as epileptic seizures or status epilepticus, whether during or immediately after surgery. With the surgical treatment of epilepsy, there is a wide selection of surgical and anesthesiological techniques that need to be carefully chosen for each individual patient and his needs. In patients with epilepsy in whom noninvasive EEG and neuroradiological imaging methods like MRI and CT are not sufficient for the localization of epileptogenic lesions, or in those in whom the lesion is located near key areas of the brain, awake craniotomy can be used along with invasive electrocorticography or cortical mapping during which it is critical to adapt the effects of anesthesia on neurophysiological functions so that epileptiform activity would not be suppressed which would make the procedure impossible.

• Keywords: anestezija; epilepsija; anestetici; kirurško liječenje epilepsije
• Keywords (english): anesthesia; epilepsy; anesthetic drugs; surgical treatment of epilepsy
• Language: croatian
• URN:NBN: urn:nbn:hr:105:594546
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-05-04 08:46:24