Anesthesia for pediatric epilepsy surgery

Epilepsy surgery for the child is increasingly being offered as a management option even in infants, due to advances in neurosurgery and pediatric neuro-anesthesia, coupled with a better understanding of neurophysiological evaluation/monitoring. Anesthesia for children in the setting of a major surgery like epilepsy surgery presents a variety of challenges. This article deals with the physiology of electroencephalogram and the effects of anesthetic agents on neurophysiology, sedation and anesthesia for investigative procedures and definitive surgery with major blood loss and fluid shifts, with special emphasis on the small child and awake craniotomy in the older child.