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Neurophysiology intraoperative monitoring

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https://www.readbyqxmd.com/read/29050170/-a-chinese-experts-consensus-of-neurophysiological-evaluating-for-microvascular-decompression
#1
(no author information available yet)
With the extensive development of microvascular decompression (MVD), perioperative neurophysiological monitoring technology is also developping rapidly in our country. To promote the standardization of neurophysiological monitoring for MVD in China, the experts consensus was published. This consensus includes five sections: indications, stimulation and recording methods, intraoperative assessment and warning criteria, influencing factors, and clinical application recommendations. Furthermore, recommendations for selection of electrophysiological monitoring and recording requirements were attached...
October 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29023306/medical-error-avoidance-in-intraoperative-neurophysiological-monitoring-the-communication-imperative
#2
Stan Skinner, Robert Holdefer, John J McAuliffe, Francesco Sala
Error avoidance in medicine follows similar rules that apply within the design and operation of other complex systems. The error-reduction concepts that best fit the conduct of testing during intraoperative neuromonitoring are forgiving design (reversibility of signal loss to avoid/prevent injury) and system redundancy (reduction of false reports by the multiplication of the error rate of tests independently assessing the same structure). However, error reduction in intraoperative neuromonitoring is complicated by the dichotomous roles (and biases) of the neurophysiologist (test recording and interpretation) and surgeon (intervention)...
October 10, 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28982108/intraoperative-neurophysiological-monitoring-motor-and-somatosensory-evoked-potentials-in-dorsal-root-entry-zone-lesioning-for-brachial-plexus-avulsion-pain
#3
Byung-Chul Son, Jin-Gyu Choi, Sang-Woo Ha, Deog-Ryeong Kim
AIMS: To address the feasibility and importance of intraoperative neurophysiological monitoring (IONM) in dorsal root entry zone (DREZ) lesioning for brachial plexus avulsion pain. METHODS: Muscle motor evoked potential (mMEP) and somatosensory evoked potential (SSEP) were applied during DREZ lesioning for brachial plexus avulsion pain. RESULTS: IONM of mMEPs and SSEPs was feasible for monitoring of the spinal cord during DREZ lesioning. With the exception of 3 unrecordable mMEPs in ipsilateral arms, mMEPs were preserved and referenced to look for changes according to lesioning in 6 upper extremities (66...
October 6, 2017: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/28974413/intradural-spinal-tumors-a-review-of-post-operative-outcomes-comparing-intramedullary-and-extramedullary-tumors-from-a-single-institution-s-experience
#4
Z X Ng, S Ng, V Nga, K J Teo, S Lwin, C Ning, T T Yeo
Intradural spinal tumors are rare and can be classified into extramedullary or intramedullary. They commonly present with symptoms such as intractable back pain or neurological deficits. We retrospectively reviewed 91 cases of intradural spinal tumors that underwent surgery in our institution from 2011 to 2016 and their assessed clinical outcomes. The majority of intradural tumors were extramedullary (89%) and the most common pathology was schwanommas (38.5%) followed by meningiomas (29.7%). Comparing extramedullary vs...
September 30, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28973400/decision-making-in-surgery-for-nonsaccular-posterior-inferior-cerebellar-artery-aneurysms-with-special-reference-to-intraoperative-assessment-of-collateral-blood-flow-and-neurophysiological-function
#5
Alessandro Narducci, Ran Xu, Peter Vajkoczy
BACKGROUND: Posterior inferior cerebellar artery (PICA) aneurysms represent a challenging pathology. PICA sacrifice is often necessary, due to the high proportion of nonsaccular aneurysms that can be found in this location. Several treatments are available, but the infrequency of these aneurysms and the increasing number of endovascular techniques have limited the development of a standardized algorithm for cases in which open surgery is indicated. OBJECTIVE: We present our series of nonsaccular PICA aneurysms, in the attempt to define an algorithm for their surgical management...
June 27, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28973360/motor-evoked-potentials-correlate-with-magnetic-resonance-imaging-and-early-recovery-after-acute-spinal-cord-injury
#6
Sanjay S Dhall, Jenny Haefeli, Jason F Talbott, Adam R Ferguson, William J Readdy, Jacqueline C Bresnahan, Michael S Beattie, Jonathan Z Pan, Geoffrey T Manley, William D Whetstone
BACKGROUND: While the utilization of neurophysiologic intraoperative monitoring with motor evoked potentials (MEPs) has become widespread in surgery for traumatic spine fractures and spinal cord injury (SCI), clinical validation of its diagnostic and therapeutic benefit has been limited. OBJECTIVE: To describe the use of intraoperative MEP at a large level I trauma center and assess the prognostic capability of this technology. METHODS: The SCI REDCap database at our institution, a level I trauma center, was queried for acute cervical SCI patients who underwent surgery with intraoperative monitoring between 2005 and 2011, yielding 32 patients...
July 7, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28971046/intraoperative-neurophysiological-monitoring-for-spinal-cord-tumor-surgery-comparison-of-motor-and-somatosensory-evoked-potentials-according-to-tumor-types
#7
Taeha Park, Jinyoung Park, Yoon Ghil Park, Joowon Lee
OBJECTIVE: To identify which combination of motor evoked potentials (MEPs) and somatosensory evoked potentials (SEPs) is most reliable for postoperative motor deterioration during spinal cord tumor surgery, according to anatomical and pathologic type. METHODS: MEPs and SEPs were monitored in patients who underwent spinal cord tumor surgery between November 2012 and August 2016. Muscle strength was examined in all patients before surgery, within 48 hours postoperatively and 4 weeks later...
August 2017: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28935546/fluorescein-guided-resection-of-intramedullary-spinal-cord-tumors-results-from-a-preliminary-multicentric-retrospective-study
#8
Francesco Acerbi, Claudio Cavallo, Karl-Michael Schebesch, Mehmet Osman Akcakaya, Camilla de Laurentis, Mustafa Kemal Hamamcioglu, Morgan Broggi, Alexander Brawanski, Jacopo Falco, Roberto Cordella, Paolo Ferroli, Telat Kiris, Julius Höhne
INTRODUCTION: IMSCTs are rare heterogenous lesions usually enhancing at pre-operative MRI, due to a damaged BBB. SF is a dye that accumulates in areas of the CNS with a damaged BBB. Given the pattern of MRI contrast-enhancement of the majority of IMSCTs, the use of this fluorescent tracer could improve tumor visualization and quality of resection. In this paper, we present the first experience on the application of fluorescein-guided technique for surgical removal of IMSCTs. METHODS: 11 patients (6 males, 5 females, mean age 50...
September 18, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28882353/neurophysiological-monitoring-in-radiofrequency-ablation-of-spinal-osteoid-osteoma-with-a-progressive-time-and-temperature-protocol-in-children
#9
Mariano A Nöel, Martin J Segura, Sergio Sierre, Ida A Francheri Wilson, Carlos A Tello, Eduardo Galaretto, Rodrigo G Remondino, María E Talarico, Ernesto S Bersusky, Lucas Piantoni
STUDY DESIGN: Retrospective. Level IV Evidence. OBJECTIVE: To assess the utility of intraoperative neurophysiological monitoring (IONM) to detect and eventually prevent impending neurovascular damage during computed tomography (CT)-guided radiofrequency ablation (RFA) of spinal osteoid osteoma (OO) in children. SUMMARY AND BACKGROUND DATA: To our knowledge, this is the first case series of spinal OO in pediatric patients treated at a single center employing IONM during RFA...
September 2017: Spine Deformity
https://www.readbyqxmd.com/read/28868196/novel-approach-to-continuous-neurophysiological-monitoring-during-surgery-of-peripheral-nerve-tumors
#10
Ángel Saponaro-González, Pedro Javier Pérez-Lorensu
BACKGROUND: Intraoperative neurophysiological monitoring (IONM) with nerve action potential (NAP) can be useful during peripheral nerve surgery. However, current methodologies are not optimized for continuous recording of the NAP. The use of newer electrodes may make it possible to more conveniently obtain continuous recordings of the NAP during surgery. METHODS: After localizing the nerve of interest and dissecting it from the adjacent soft tissue, two APS(®) (Automatic Periodic Stimulation) electrodes, originally designed for stimulation of the vagus nerve during thyroid surgery, are placed on the nerve on either sides of the tumor for stimulation and recording using two subdermal electroencephalogram (EEG) needles as anode and reference, respectively...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28863007/intraoperative-neurophysiologic-monitoring-for-prediction-of-postoperative-neurological-improvement-in-a-child-with-chiari-type-i-malformation
#11
Yukari Kawasaki, Susumu Uchida, Kouhei Onishi, Masako Toyokuni, Kazuo Okanari, Minoru Fujiki
INTRODUCTION: Although many surgical treatment strategies for Chiari malformation type I (CM-I) have been reported, the most appropriate surgical technique remains controversial. It is wholly ascribable to the complicacy of pathological condition in CM-I. Recently, intraoperative neurophysiologic monitoring (INM) is becoming prevalent in spinal surgery. Indeed, motor-evoked potentials (MEPs) monitoring and somatosensory-evoked potentials (SSEPs) monitoring are standard tools to minimize the risk of neurologic injury and postoperative deficits...
October 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28842233/pattern-of-corticospinal-projections-defined-by-brain-mapping-during-resective-epilepsy-surgery-in-a-patient-with-congenital-hemiparesis-and-intractable-epilepsy
#12
Chen-Ya Yang, Hsin-Hung Chen, Chien Chen, Jan-Wei Chiu, Chen-Liang Chou, Tsui-Fen Yang
BACKGROUND: Congenital or early acquired brain structural lesions often cause contralateral hemiparesis as well as cognitive deficits, developmental delays, and seizures. Among them, seizure is the most debilitating condition, as it greatly impairs the quality of life in both the affected individuals and their caregivers and prevents them from active social participation. CASE DESCRIPTION: Here, we present a 34-year-old man with hemiparesis and early-onset seizures since childhood owing to a congenital brain lesion...
August 22, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28840256/-neurophysiological-monitoring-during-surgical-procedures
#13
REVIEW
P Michels, A Bräuer, M Bauer, M Söhle
The application of intraoperative neurophysiological monitoring (IONM) is gaining more and more importance in daily clinical practice. The use of IONM allows the localization of neural structures and to control functioning of the peripheral and central nervous systems in anesthetized patients. This enables surgeons to identify and to protect neural structures and cerebral areas. The use of IONM also enables anesthesiologists to adjust anesthesia and cardiopulmonary therapy to the individual needs of the patient...
August 24, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28805756/-an-experience-of-neurophysiological-monitoring-in-neurosurgery
#14
A G Vasyatkina, E A Levin, K Yu Orlov, V V Kobozev
AIM: To evaluate the efficacy of neuromonitoring methods in prevention of postoperative neurological complications and estimation of predictive power of intraoperative changes in monitored characteristics. MATERIAL AND METHODS: Retrospective study examined 240 patients, operated in the years 2014-2015 using intraoperative neurophysiological monitoring. One hundred and seventy-three patients suffered from hemispheric lesions and 67 had lesions located in or near the brainstem...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28766024/usefulness-of-intraoperative-electromyographic-monitoring-of-oculomotor-and-abducens-nerves-during-skull-base-surgery
#15
Zi-Yi Li, Ming-Chu Li, Jian-Tao Liang, Yu-Hai Bao, Ge Chen, Hong-Chuan Guo, Feng Ling
BACKGROUND: Intraoperative neurophysiologic monitoring of the extraocular cranial nerve (EOCN) is not commonly performed because of technical difficulty and risk, reliability of the result and predictability of the postoperative function of the EOCN. METHODS: We performed oculomotor nerve (CN III) and abducens nerve (CN VI) intraoperative monitoring in patients with skull base surgery by recording the spontaneous muscle activity (SMA) and compound muscle action potential (CMAP)...
August 2, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28761524/selective-dorsal-rhizotomy-a-multidisciplinary-approach-to-treating-spastic-diplegia
#16
Hussam Abou Al-Shaar, Muhammad Tariq Imtiaz, Hazem Alhalabi, Shara M Alsubaie, Abdulrahman J Sabbagh
BACKGROUND: Spasticity is a motor disorder that interferes with mobility and affects the quality of life. Different approaches have been utilized to address patients with spastic diplegia, among which is selective dorsal rhizotomy (SDR). Although SDR has been shown to be efficacious in treating spastic patients, many neurologists and neurosurgeons are not well aware of the procedure, its indications, and expected outcomes due to the limited number of centers performing this procedure...
July 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28758184/motor-evoked-potentials-and-bis-guided-anaesthesia-in-image-guided-mini-invasive-neurosurgery-of-supratentorial-tumors-nearby-the-cortico-spinal-tract
#17
Roberto Cordella, Eleonora Orena, Francesco Acerbi, Elena Beretta, Dario Caldiroli, Francesco Dimeco, Carla Carozzi
AIM: to describe and evaluate the anaesthesiological regimen used in neurophysiologically monitored image-guided mini-invasive neurosurgery. MATERIAL AND METHODS: 24 patients underwent elective surgery under general anaesthesia that was administered through Target Controlled Infusion (TCI) for effect-site concentration (Ce) of Propofol and Remifentanil, targeting Bispectral Index (BIS) in the 40-60 intervals. Stimulating intensity of transcranial motor evoked potentials (tMEP), BIS index, Propofol and Remifentanil Ce were collected at MEPs threshold (T) definition (respectively BIS@T, CeProp@T and CeRemi@T)...
June 14, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28719456/warning-criteria-for-intraoperative-neurophysiologic-monitoring
#18
Quanmeng Liu, Qinzhou Wang, Hongen Liu, William K K Wu, Matthew T V Chan
PURPOSE OF REVIEW: Intraoperative changes in somatosensory (SEP) and motor evoked potentials (MEPs) may indicate potential injury to the spinal cord and will require timely intervention to prevent permanent damage. This review focuses on the validity of currently recommended warning criteria for intraoperative evoked potential monitoring. RECENT FINDINGS: Current guideline recommends a decrease in SEP amplitude by 50% and MEP amplitude by 50-100% as warning signals for injury to the ascending sensory and descending motor pathway, respectively...
October 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28713053/perils-of-intraoperative-neurophysiological-monitoring-analysis-of-false-negative-results-in-spine-surgeries
#19
Arvydas A Tamkus, Kent S Rice, Michael T McCaffrey
BACKGROUND CONTEXT: Although some authors have published case reports describing false negatives in intraoperative neurophysiological monitoring (IONM), a systematic review of causes of false-negative IONM results is lacking. PURPOSE: The objective of this study was to analyze false-negative IONM findings in spine surgery. STUDY DESIGN: This is a retrospective cohort analysis. PATIENT SAMPLE: A cohort of 109 patients with new postoperative neurologic deficits was analyzed for possible false-negative IONM reporting...
July 13, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28689398/an-electrode-configuration-for-recording-muscle-motor-evoked-potentials-in-the-upper-extremities-during-intraoperative-neurophysiological-monitoring
#20
Young-Doo Choi, Seung-Hyun Jin, Chi-Heon Kim, Gil Ho Kwak, Bo Eun Kim, Chun Kee Chung
OBJECTIVE: The main aim of the present study is to examine the electrode configurations used to record the muscle motor evoked potential (mMEP) in the upper extremities during surgery with the goal of producing a high and stable mMEP signal, in particular among the abductor pollicis brevis (APB), abductor digiti minimi (ADM), and across the APB-ADM muscles, which have been widely used for the mMEP in the upper extremities. METHODS: Thirty right-handed patients were recruited in this prospective study...
July 2017: Journal of Korean Neurosurgical Society
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