Transcranial High-frequency Repetitive Electrical Stimulation for Recording Myogenic Motor Evoked Potentials with the Patient under General Anesthesia

Pechstein, U.; Cedzich, C.; Nadstawek, J.; Schramm, Johannes

doi:10.1097/00006123-199608000-00020

Cited by 239 publications

(75 citation statements)

References 30 publications

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“…The Tc-MEPs induced by multiple stimuli were much less sensitive to the effects of general anesthesia than those evoked by a single stimulus. 10,21,27 Somatosensory evoked potentials were traditionally used by various investigators to evaluate cerebral function in procedures involving intracranial aneurysms and tumors. 6,7,19,24,28 Recently, its utility has been extended to the resection of intramedullary spinal cord tumors and extraaxial spinal cord tumors.…”

Section: Neuromonitoring Techniquesmentioning

confidence: 99%

Spinal meningiomas: surgical management and outcome

Gottfried

Gluf

Quiñones‐Hinojosa

et al. 2003

FOC

191

163

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Advances in imaging and surgical technique have improved the treatment of spinal meningiomas; these include magnetic resonance imaging, intraoperative ultrasonography, neuromonitoring, the operative microscope, and ultrasonic cavitation aspirators. This study is a retrospective review of all patients treated at a single institution and with a pathologically confirmed diagnosis of spinal meningioma. Additionally the authors analyze data obtained in 556 patients reported in six large series in the literature, evaluating surgical techniques, results, and functional outcomes. Overall, surgical treatment of spinal meningiomas is associated with favorable outcomes. Spinal meningiomas can be completely resected, are associated with postoperative functional improvement, and the rate of recurrence is low.

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Section: Neuromonitoring Techniquesmentioning

confidence: 99%

Spinal meningiomas: surgical management and outcome

Gottfried

Gluf

Quiñones‐Hinojosa

et al. 2003

FOC

191

163

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“…Transcranial MEPs have become a critical modality for intraoperative monitoring of motor pathway integrity in spine surgery, and the technical aspects and safety of MEP monitoring have previously been demonstrated (14,21,27). Combining MEPs with SEPs has been recommended in intracranial aneurysm surgery, and MEPs have been found to be superior to SEPs in many situations during cerebral aneurysm surgery (4,23).…”

Section: Introductionmentioning

confidence: 99%

The Incidence of Unacceptable Movement with Motor Evoked Potentials During Craniotomy for Aneurysm Clipping

et al. 2014

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“…The introduction of transcranially motor evoked potentials (MEPs) represented a significant step forward for intraoperative assessment of motor pathway function in spine surgery [1][2][3][4][5][6][7]. Two methodologies have been developed to elicit MEPs by transcranial electrical stimulation [7]:…”

Section: Introductionmentioning

confidence: 99%

“…Recording the D wave directly from the epidural space (e-MEPs; in this study e-MEPs and D wave are used as synonyms) evoked by a single electrical shock (single pulse technique) [1,2]; 2. Recording of MEPs in limb muscles (m-MEPs) elicited by a short train of electrical stimuli (multipulse technique) [4,5].…”

Section: Introductionmentioning

confidence: 99%

Relevance of intraoperative D wave in spine and spinal cord surgeries

2012

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Purpose The combined recordings of epidural-(D wave) and muscle motor evoked potentials (m-MEPs) have been proposed in many studies in intramedullary spinal cord tumour (IMSCT) surgery, although not all agree. Furthermore, the usefulness of the intraoperative monitoring of motor systems using these methods in other types of spine surgery has not yet been clearly confirmed. The aim of this study is to test the impact of intraoperative D wave on the monitorability and motor outcome in spine surgery. Methods Intraoperative recording of posterior tibial nerve somatosensory potentials, lower limb m-MEPs (LLmMEPs) and epidurally recorded D wave caudally to the surgical level was attempted in a total of 103 spine and spinal cord surgeries (23 IMSCT, 55 extramedullary spinal cord tumours and 25 myelopathies). Results There was a 97.1 %, overall monitorability where at least 1 of the 3 modalities was applicable in 100 surgical procedures. Baseline LLm-MEPs were recorded bilaterally in 85 cases and unilaterally in 11. A caudal D wave was recorded in 97 cases. Transient, or persistent intraoperative modifications occurred in 14/23 IMSCT, 5/55 extramedullary spinal cord tumours and in 2/25 myelopathies. The presence of a persistent stable caudal D wave was predictive of a good motor outcome even when the LL-MEPs were absent and/or when lost during surgery.Conclusions Not only is intraoperative D wave recording to be considered mandatory in IMSCT surgery but it should also be attempted in other types of spine/spinal cord surgeries.

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Transcranial High-frequency Repetitive Electrical Stimulation for Recording Myogenic Motor Evoked Potentials with the Patient under General Anesthesia

Cited by 239 publications

References 30 publications

Spinal meningiomas: surgical management and outcome

Spinal meningiomas: surgical management and outcome

The Incidence of Unacceptable Movement with Motor Evoked Potentials During Craniotomy for Aneurysm Clipping

Relevance of intraoperative D wave in spine and spinal cord surgeries

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