J Korean Med Sci.  2006 Jun;21(3):495-499. 10.3346/jkms.2006.21.3.495.

Postoperative Electroencephalogram for Follow up of Pediatric Moyamoya Disease

• Kim DS
• Ko TS
• Ra YS
• Choi CG

• KMID: 1778435
• DOI: http://doi.org/10.3346/jkms.2006.21.3.495

Abstract

It is well known that the electroencephalographic finding in patients with moyamoya disease demonstrates the characteristic "re-build up" phenomenon a few minutes after hyperventilation. To evaluate the usefulness of an electroencephalogram (EEG) in the postoperative management of children with moyamoya disease, we studied the presence or absence of improvement in the clinical, single photon emission computed tomography (SPECT) and EEG findings, before and after surgery. Twenty-two patients, who underwent indirect revascularization surgery for moyamoya disease, were included in our study. Clinical improvement was assessed as the disappearance or decrease of a transient ischemic attack or headache. The findings on the EEG and SPECT were considered improved when the re-build up phenomenon was absent and when there was improvement in the cerebrovascular reserve as a result of the acetazolamide challenge test. The statistical correlation analysis for both clinical and EEG improvement were consistent (kappa value=0.409, p< 0.05). However, the result from the clinical and SPECT improvement as well as that from EEG and SPECT improvement were not statistically significant. Our results suggest that EEG can be used as a noninvasive and simple follow-up test for moyamoya disease after indirect revascularization surgery if the hyperventilation procedure is effectively performed during EEG recording.

Keyword

Moyamoya Disease; Electroencephalography; Follow-up Studies

MeSH Terms

Tomography, Emission-Computed, Single-Photon/methods
Postoperative Period
Moyamoya Disease/*diagnosis/*therapy
Models, Statistical
Male
Ischemic Attack, Transient/diagnosis
Humans
Headache/diagnosis
Female
Electroencephalography/*methods
Child, Preschool
Child
Cerebral Revascularization
Adolescent

Figure

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  Fig. 1 Preoperative electroencephalographic findings before and after hyperventilation (11 yr old boy). (A) Before hyperventilation, (B) At the end of hyperventilation and (C) 90 sec after hyperventilation. The "re-build up" phenomenon is observed over the left hemisphere after hyperventilation (C).

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