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Electrocorticographic and neurochemical findings after local cortical valproate application in patients with pharmacoresistant focal epilepsy
Author(s) -
Altenmüller DirkMatthias,
Hebel Jonas M.,
Deniz Cagan,
Volz Silvanie,
Zentner Josef,
Feuerstein Thomas J.,
Moser Andreas
Publication year - 2020
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/epi.16523
Subject(s) - epilepsy , neurochemical , glutamate receptor , tolerability , neuroscience , excitatory postsynaptic potential , inhibitory postsynaptic potential , electrocorticography , anticonvulsant , epilepsy surgery , medicine , psychology , anesthesia , pharmacology , receptor , adverse effect
Because oral pharmacological treatment of neocortical focal epilepsy is limited due to common systemic side effects and relatively low drug concentrations reached at the epileptic foci locally, application of antiepileptic agents directly onto the neocortical focus may enhance treatment tolerability and efficacy. We describe the effects of cortically applied sodium valproate (VPA) in two patients with pharmacoresistant neocortical focal epilepsy who were selected for epilepsy surgery after a circumscribed epileptic focus had been determined by invasive presurgical evaluation using subdural electrodes. Local VPA modified epileptic activity as electrocorticographically recorded from the chronic focus in both patients. In addition, VPA induced local increase of the inhibitory neurotransmitter γ‐aminobutyric acid (GABA) in cortical tissue samples, whereas the excitatory glutamate was possibly decreased. In this clinical pilot study, we could show antiepileptic effects of cortically applied VPA in humans by electrocorticographic and neurochemical parameters.