Transcranial Motor Evoked Potentials

Jameson, Leslie C.

doi:10.1007/978-1-4614-0308-1_2

Cited by 12 publications

(2 citation statements)

References 63 publications

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“…IONM provides high sensitivity and specificity for the detection of spinal cord injury. Relative contraindications include seizure history, skull defects, intracranial electrodes, vascular clips, and cardiac pacemakers 13 . Despite most contraindications having fallen by the wayside, CI remains a contraindication 6,14 .…”

Section: Discussionmentioning

confidence: 99%

Neurophysiological Intraoperative Monitoring in Patients with Cochlear Implant Undergoing Posterior Spinal Fusion

Pan

Adeyemo

Armstrong

et al. 2022

JBJS Case Connector

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Case:Transcranial electric stimulation motor-evoked potentials (tcMEPs) are the most sensitive technique in multimodality intraoperative neuromonitoring (IONM) for posterior spinal fusion (PSF). The presence of a cochlear implant (CI) is considered a contraindication to IONM because of theoretical risk of implant device and local tissue damage from voltages induced by tcMEPs. We present the case of a 10-year-old girl with CI who underwent successful PSF with tcMEP and monopolar electrocautery (MoEC) without perioperative complications or CI damage.Conclusion:With proper precautions, such as MoEC usage at a minimal voltage, motor-evoked potential monitoring can be safely performed in pediatric patients with CI undergoing PSF.

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Section: Discussionmentioning

confidence: 99%

Neurophysiological Intraoperative Monitoring in Patients with Cochlear Implant Undergoing Posterior Spinal Fusion

Pan

Adeyemo

Armstrong

et al. 2022

JBJS Case Connector

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“…In lumbar surgery, neuromonitoring is primarily needed at the lumbosacral levels. Limiting the stimulus to an area just proximal to the nerves of interest can reduce the unnecessary effects that may occur with concomitant upper extremity and cranial nerve stimulation [ 11 - 12 ]. Here, we presented TaMAPs in two porcine models.…”

Section: Discussionmentioning

confidence: 99%

Novel Transabdominal Motor Action Potential (TaMAP) Neuromonitoring System for Spinal Surgery

Hoshide¹,

Feldman²,

Gabel³

et al. 2016

Cureus

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IntroductionMinimally invasive lateral lumbar interbody fusion (LLIF) approaches to the lumbar spine reduce patient morbidity compared to anterior or posterior alternatives. This approach, however, decreases direct anatomical visualization, creating the need for highly sensitive and specific neurophysiological monitoring. We seek to determine feasibility in 'transabdominal motor action potential (TaMAP)' monitoring as an assessment for the integrity of the neural elements during lateral-approach surgeries to the lumbar spine. MethodsCathode and anode leads were placed on the posterior and anterior surfaces of two porcine subjects. Currents of varying degrees were transmitted across, from front to back. Motor responses were monitored and recorded by needle electrodes in specific distal muscle groups of the lower extremity. Lastly, the cathode and anode were placed anterior and posterior to the chest wall and stimulated to the maximum of 1500 mA to determine any effect on cardiac rhythm.ResultsResponses were seen by measuring vertical height differences between peaks of corresponding evoked potentials. Recruitment began at 200 mA in the lower extremities. Stimulation at 450 mA recruited a reliable and distinguishable electrographic response from most muscle groups. Responses were recorded and reliably measured and increased in proportion to the graduation of transabdominal stimulation current; no responses were seen in the arms or face. 1500 mA across the chest wall failed to stimulate or induce cardiac arrhythmia on repeated stimulation, indicating safety of stimulation.ConclusionTaMAPs seen in the animal model provide a potential alternative to standard transcranial motor evoked potentials done in the lateral approach of LLIFs. TaMAP recordings in most muscle groups were recordable and reliable, though some muscle groups failed to stimulate. Safety of transabdominal motor evoked potentials was confirmed in this porcine study. Future studies should examine TaMAPs reliability in detecting compressive lesions of nerve roots and peripheral nerves.

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The Use of Spinal Reflex Responses for IOM

Leppanen

2022

Koht, Sloan, Toleikis's Monitoring the Nervous System for Anesthesiologists and Other Health Care Professionals

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Transcranial Motor Evoked Potentials

Cited by 12 publications

References 63 publications

Neurophysiological Intraoperative Monitoring in Patients with Cochlear Implant Undergoing Posterior Spinal Fusion

Neurophysiological Intraoperative Monitoring in Patients with Cochlear Implant Undergoing Posterior Spinal Fusion

Novel Transabdominal Motor Action Potential (TaMAP) Neuromonitoring System for Spinal Surgery

The Use of Spinal Reflex Responses for IOM

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