Influence of anesthetic management on quality of magnetoencephalography scan data in pediatric patients: a case series

BACKGROUND: Magnetoencephalography (MEG) is increasingly used in the presurgical evaluation of pediatric seizure patients. Many pediatric patients require sedation or anesthesia to tolerate these exams. However, the available literature on anesthetic management in this population is very limited. METHODS: We retrospectively reviewed the records of all patients who underwent MEG scanning at our institution with regard to the interaction of anesthetic management and quality of scan data. RESULTS: High-dose propofol infusions (> or =200 microg.kg(-1).min(-1)) were associated with high frequency artifacts that interfered with the identification of epileptiform discharges. Lower-dose propofol infusions (< or =100 microg.kg(-1).min(-1)) did not produce artifacts but required co-administration of fentanyl to prevent patient motion. Dexmedetomidine infusions were not associated with signal artifacts and prevented patient motion very well in our initial patients and became our standard technique. CONCLUSION: In our experience, dexmedetomidine infusions are preferable to propofol-based techniques for pediatric MEG scans due to the absence of adverse effect on interictal activity.