keyword
https://read.qxmd.com/read/38433484/advancing-intraoperative-neurophysiological-monitoring-with-human-reflexes
#1
REVIEW
Jongsuk Choi, Alba Díaz-Baamonde, María de Los Ángeles Sánchez Roldán, Ana Mirallave Pescador, Jun-Soon Kim, Maria J Téllez, Kyung Seok Park, Vedran Deletis
Human reflexes are simple motor responses that are automatically elicited by various sensory inputs. These reflexes can provide valuable insights into the functioning of the nervous system, particularly the brainstem and spinal cord. Reflexes involving the brainstem, such as the blink reflex, laryngeal adductor reflex, trigeminal hypoglossal reflex, and masseter H reflex, offer immediate information about the cranial-nerve functionality and the overall state of the brainstem. Similarly, spinal reflexes such as the H reflex of the soleus muscle, posterior root muscle reflexes, and sacral reflexes provide crucial information about the functionality of the spinal cord and peripheral nerves...
March 2024: Journal of Clinical Neurology
https://read.qxmd.com/read/38306219/intraoperative-neurophysiologic-monitoring-and-mapping-during-surgery-on-intramedullary-spinal-cord-tumors-in-children-and-adolescents
#2
JOURNAL ARTICLE
Kathleen Seidel, Vedran Deletis, Andreas Raabe, Katharina Lutz, Philippe Schucht
Surgical resection of intramedullary spinal cord tumors carries significant risks of neurologic deficits, especially in cases of infiltrative tumors. In pediatric patients, this type of surgery may be associated with a high risk of poor neurologic outcome. Intraoperative neurophysiologic monitoring has been adopted as part of the clinical routine by many centers as a useful adjunct for intraoperative assessment of neurologic integrity. To what extent intraoperative neurophysiologic mapping strategies may further support intraoperative decision-making is still a matter of debate...
February 1, 2024: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://read.qxmd.com/read/38306218/intraoperative-neurophysiologic-monitoring-and-mapping-in-children-undergoing-brainstem-surgery
#3
JOURNAL ARTICLE
Vedran Deletis, Kathleen Seidel, Isabel Fernández-Conejero
Intraoperative neurophysiologic monitoring during surgery for brainstem lesions is a challenge for intraoperative neurophysiologists and surgeons. The brainstem is a small structure packed with vital neuroanatomic networks of long and short pathways passing through the brainstem or originating from it. Many central pattern generators exist within the brainstem for breathing, swallowing, chewing, cardiovascular regulation, and eye movement. During surgery around the brainstem, these generators need to be preserved to maintain their function postoperatively...
February 1, 2024: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://read.qxmd.com/read/37973442/in-memoriam-vedran-deletis-1946-2023
#4
JOURNAL ARTICLE
Isabel Fernández-Conejero, Francesco Sala, Kathleen Seidel, Jay Shils, Andrea Szelényi, Sedat Ulkatan, Javier Urriza
No abstract text is available yet for this article.
November 14, 2023: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://read.qxmd.com/read/37945710/deep-brain-stimulation-in-disorders-of-consciousness-10%C3%A2-years-of-a-single-center-experience
#5
JOURNAL ARTICLE
Darko Chudy, Vedran Deletis, Veronika Paradžik, Ivan Dubroja, Petar Marčinković, Darko Orešković, Hana Chudy, Marina Raguž
Disorders of consciousness (DoC), namely unresponsive wakefulness syndrome (UWS) and minimally conscious state (MCS), represent severe conditions with significant consequences for patients and their families. Several studies have reported the regaining of consciousness in such patients using deep brain stimulation (DBS) of subcortical structures or brainstem nuclei. Our study aims to present the 10 years' experience of a single center using DBS as a therapy on a cohort of patients with DoC. Eighty Three consecutive patients were evaluated between 2011 and 2022; entry criteria consisted of neurophysiological and neurological evaluations and neuroimaging examinations...
November 9, 2023: Scientific Reports
https://read.qxmd.com/read/37782325/vedran-deletis-md-phd-1946-2023
#6
EDITORIAL
Francesco Sala
No abstract text is available yet for this article.
October 2, 2023: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://read.qxmd.com/read/37770680/brainstem-surgery-functional-surgical-anatomy-with-the-use-of-an-advanced-modern-intraoperative-neurophysiological-procedure
#7
JOURNAL ARTICLE
Nobuhito Morota, Vedran Deletis
Intraoperative neurophysiology (ION) in brainstem surgery evolved as brainstem surgery advanced.The original idea of brainstem mapping (BSM) is a neurophysiological procedure to locate cranial nerve motor nuclei (CNMN) on the floor of the fourth ventricle. With the introduction of various skull base approaches to the brainstem, BSM is carried out on any surface of the brainstem to expose the safe entry zone to the intrinsic brainstem lesion. It is the modern concept of BSM, a broader definition of BSM. BSM enables to avoid direct damage to the CNMN when approaching the brainstem through the negative mapping region...
2023: Advances and Technical Standards in Neurosurgery
https://read.qxmd.com/read/37539385/dysfunctional-connectivity-as-a-neurophysiologic-mechanism-of-disorders-of-consciousness-a-systematic-review
#8
REVIEW
Gabriela Plosnić, Marina Raguž, Vedran Deletis, Darko Chudy
INTRODUCTION: Disorders of consciousness (DOC) has been an object of numbers of research regarding the diagnosis, treatment and prognosis in last few decades. We believe that the DOC could be considered as a disconnection syndrome, although the exact mechanisms are not entirely understood. Moreover, different conceptual frameworks highly influence results interpretation. The aim of this systematic review is to assess the current knowledge regarding neurophysiological mechanisms of DOC and to establish possible influence on future clinical implications and usage...
2023: Frontiers in Neuroscience
https://read.qxmd.com/read/36274572/intraoperative-bulbocavernosus-reflex-monitoring-in-posterior-lumbar-fusion-surgery
#9
JOURNAL ARTICLE
Jongsuk Choi, Jun-Soon Kim, Seung-Jae Hyun, Ki-Jeong Kim, Ho-Joong Kim, Vedran Deletis, Kyung Seok Park
OBJECTIVE: To assess the utility of intraoperative bulbocavernosus reflex (BCR) monitoring in posterior lumbar fusion surgery. METHODS: We retrospectively evaluated 153 patients undergoing posterior lumbar fusion with intraoperative BCR monitoring. Voiding function was assessed at discharge and two follow-ups. RESULTS: BCR was preserved in 151 patients and completely disappeared in two patients at the end of surgery. For patients in whom BCR was preserved, voiding difficulties at discharge and 1-month and 6-month follow-ups were noted in 16 (10...
December 2022: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://read.qxmd.com/read/36081239/intraoperative-monitoring-of-facial-corticobulbar-motor-evoked-potentials-methodological-improvement-and-analysis-of-100-patients
#10
JOURNAL ARTICLE
Isabel Fernández-Conejero, Sedat Ulkatan, Chandranath Sen, Julia Miró Lladó, Vedran Deletis
OBJECTIVE: A) To describe an improved methodology for continuously monitoring the functional integrity of facial nerve by eliciting facial corticobulbar motor-evoked potentials (FCoMEP) and B) To establish the prognosis of facial nerve function based on changes in FCoMEP during skull base surgery. METHODS: Intraoperative monitoring of FCoMEP performed in 100 patients. Previously published methodology has been improved upon by a) doing preoperative mapping of the facial nerve, b) facilitating the corticobulbar tract (CBT) by continuous transcranial electrical stimulation (TES) at 2 Hz repetition rate, c) recording from multiple facial nerve innervated muscles, and d) eliciting blink reflex (BR)...
October 2022: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://read.qxmd.com/read/35796266/advances-in-intraoperative-neurophysiology-during-microvascular-decompression-surgery-for-hemifacial-spasm
#11
REVIEW
Byung-Euk Joo, Jun-Soon Kim, Vedran Deletis, Kyung Seok Park
Microvascular decompression (MVD) is a widely used surgical intervention to relieve the abnormal compression of a facial nerve caused by an artery or vein that results in hemifacial spasm (HFS). Various intraoperative neurophysiologic monitoring (ION) and mapping methodologies have been used since the 1980s, including brainstem auditory evoked potentials, lateral-spread responses, Z-L responses, facial corticobulbar motor evoked potentials, and blink reflexes. These methods have been applied to detect neuronal damage, to optimize the successful decompression of a facial nerve, to predict clinical outcomes, and to identify changes in the excitability of a facial nerve and its nucleus during MVD...
July 2022: Journal of Clinical Neurology
https://read.qxmd.com/read/35772888/intraoperative-neurophysiology-in-intramedullary-spinal-cord-tumor-surgery
#12
REVIEW
Francesco Sala, Benjamin Skrap, Karl F Kothbauer, Vedran Deletis
Intramedullary spinal cord tumor (ISCT) surgery is challenged by a significant risk of neurological injury. Indeed, while most ISCT patients arrive to surgery in good neurological condition due to early diagnosis, many experience some degree of postoperative sensorimotor deficit. Thus, intraoperative neuromonitoring (IONM) is invaluable for providing functional information that helps neurosurgeons tailor the surgical strategy to maximize resection while minimizing morbidity. Somatosensory evoked potential (SEP), muscle motor evoked potential (mMEP), and D-wave monitoring are routinely used to continuously assess the functional integrity of the long pathways within the spinal cord...
2022: Handbook of Clinical Neurology
https://read.qxmd.com/read/35772885/monitoring-cerebellopontine-angle-and-skull-base-surgeries
#13
REVIEW
Isabel Fernández-Conejero, Sedat Ulkatan, Vedran Deletis
Cerebellopontine angle (CPA) surgery represents a challenge for neurosurgeons due to the high risk of iatrogenic injury of vital neurological structures. Therefore, important efforts in improving the surgical techniques and intraoperative neurophysiology have been made in the last decades. We present a description and review of the available methodologies for intraoperative neuromonitoring and mapping during CPA surgeries. There are three main groups of techniques to assess the functional integrity of the nervous structures in danger during these surgical procedures: (1) Electrical identification or mapping of motor cranial nerves (CNs), which is essential in order to locate the nerve in their different parts during the tumor resection; (2) Monitoring, which provides real-time information about functional integrity of the nervous tissue; and (3) Brainstem reflexes including blink reflex, masseteric reflex, and laryngeal adductor reflex...
2022: Handbook of Clinical Neurology
https://read.qxmd.com/read/35772884/mapping-and-monitoring-of-brainstem-surgery
#14
REVIEW
Kunihiko Kodama, Karl F Kothbauer, Vedran Deletis
The surgical morbidity of brainstem lesions is higher than in other areas of the central nervous system because the compact brainstem is highly concentrated with neural structures that are often distorted or even unrecognizable under microscopic view. Intraoperative neurophysiologic mapping helps identify critical neural structures to avoid damaging them. With the trans-fourth ventricular floor approach, identifying the facial colliculi and vagal and hypoglossal triangles enables incising and approaching the brainstem through the safe entry zones, the suprafacial or infrafacial triangle, with minimal injury...
2022: Handbook of Clinical Neurology
https://read.qxmd.com/read/35715282/effects-of-10-khz-subthreshold-stimulation-on-human-peripheral-nerve-activation
#15
JOURNAL ARTICLE
Vedran Deletis, Jay Shils, Juan Anso, Eduardo Villar Ortega, Laura Marchal-Crespo, Karin A Buetler, Andreas Raabe, Kathleen Seidel
OBJECTIVE: The mechanisms of action of high-frequency stimulation (HFS) are unknown. We investigated the possible mechanism of subthreshold superexcitability of HFS on the excitability of the peripheral nerve. MATERIALS AND METHODS: The ulnar nerve was stimulated at the wrist in six healthy participants with a single (control) stimulus, and the responses were compared with the responses to a continuous train of 5 seconds at frequencies of 500 Hz, 2.5 kHz, 5 kHz, and 10 kHz...
June 14, 2022: Neuromodulation: Journal of the International Neuromodulation Society
https://read.qxmd.com/read/33623134/structural-changes-in-brains-of-patients-with-disorders-of-consciousness-treated-with-deep-brain-stimulation
#16
JOURNAL ARTICLE
Marina Raguž, Nina Predrijevac, Domagoj Dlaka, Darko Orešković, Ante Rotim, Dominik Romić, Fadi Almahariq, Petar Marčinković, Vedran Deletis, Ivica Kostović, Darko Chudy
Disorders of consciousness (DOC) are one of the major consequences after anoxic or traumatic brain injury. So far, several studies have described the regaining of consciousness in DOC patients using deep brain stimulation (DBS). However, these studies often lack detailed data on the structural and functional cerebral changes after such treatment. The aim of this study was to conduct a volumetric analysis of specific cortical and subcortical structures to determine the impact of DBS after functional recovery of DOC patients...
February 23, 2021: Scientific Reports
https://read.qxmd.com/read/33293231/in-memoriam-karl-kothbauer-md-1962-2020
#17
JOURNAL ARTICLE
Francesco Sala, Vedran Deletis, Kathleen Seidel, Isabel Fernandez-Conejero
No abstract text is available yet for this article.
January 2021: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://read.qxmd.com/read/33272821/neurophysiological-monitoring-of-the-laryngeal-adductor-reflex-during-cerebellar-pontine-angle-and-brainstem-surgery
#18
JOURNAL ARTICLE
Maria J Téllez, Ana Mirallave-Pescador, Kathleen Seidel, Javier Urriza, Alireza Shoakazemi, Andreas Raabe, Saadi Ghatan, Vedran Deletis, Sedat Ulkatan
OBJECTIVE: To correlate intraoperative changes of the laryngeal adductor reflex (LAR), alone or in combination with corticobulbar motor evoked potential of vocal muscles (vocal-CoMEPs), with postoperative laryngeal function after posterior fossa and brainstem surgery. METHODS: We monitored 53 patients during cerebellar-pontine angle and brainstem surgeries. Vocal-CoMEPs and LAR were recorded from an endotracheal tube with imbedded electrodes or hook-wires electrodes...
February 2021: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://read.qxmd.com/read/32638074/selective-dorsal-rhizotomy-functional-anatomy-of-the-conus-cauda-and-essentials-of-intraoperative-neurophysiology
#19
JOURNAL ARTICLE
Claudia Pasquali, Vedran Deletis, Francesco Sala
INTRODUCTION: Spasticity is the result of an exaggeration of the monosynaptic muscle stretch reflex due to lesions affecting the central nervous system, in particular an upper motor neuron lesion. Selective dorsal rhizotomy (SDR) is a surgical technique developed to treat spastic diplegia, one of the common forms of cerebral palsy, resulting from the lack of supraspinal inhibitory controls. The aim of SDR is to identify and cut a critical amount of the sensory rootlets, in particular those contributing the most to spasticity, in order to relieve the patient from lower limb spasticity while preserving motor strength and sphincter control...
September 2020: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://read.qxmd.com/read/31895134/a-new-methodology-for-intraoperative-monitoring-of-the-functional-integrity-of-the-phrenic-nerve-during-cardiothoracic-surgery
#20
JOURNAL ARTICLE
Giuseppe Lucente, Carlos Martinez-Barenys, Alba Ramos-Fransi, Miriam Almendrote-Muñoz, Pedro López de Castro, Vedran Deletis, Jaume Coll-Canti, Alicia Martínez-Piñeiro
INTRODUCTION: The phrenic nerve could be easily injured during cardiothoracic surgeries because of its anatomical relationships. The aim of this study is to describe a new, feasible, and reproducible methodology to achieve a continuous intraoperative neuromonitoring of the phrenic nerve. METHODS: Consecutive patients who underwent open-chest surgery were included. The recording active electrode was placed 5 cm superior to the tip of the xiphoid process, and a hook wire inserted at the motor point of the ipsilateral hemidiaphragm was used as the reference electrode...
May 1, 2021: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
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