[Function-controlled neurosurgery. Neurophysiologic and neuropsychological monitoring during surgery of the nervous system].

Neuromonitoring of neural structures has become increasingly common during surgery near cortical areas representing sensorimotor and language function (epilepsia, tumors), in the brain stem and the spinal cord (tumors), near cranial nerves (cerebellopontine angle tumors, trigeminal neuralgia, hemifacial spasm), and in the cauda equina (tumors, tethered spinal cord). The technical spectrum to monitor these operations includes electrical cortical stimulation to evoke sensorimotor phenomena and language disturbances, electroneurography and -myography of the cauda equina, motor cranial nerves and nuclei, and somatosensory, motor and acoustic evoked potentials. The goals of intraoperative neuromonitoring are: (1) minimizing the risk of suffering neurological and neuropsychological injury as a result of surgery; (2) extending the surgical spectrum to lesions that have previously been considered inoperable or hazardous to operate upon; (3) intraoperative electrophysiological documentation that the goal of surgery has been achieved; (4) intraoperative basic research.