Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2019
Direct cortical stimulation with cylindrical depth electrodes in the interhemispheric fissure for leg motor evoked potential monitoring.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Brage Liberto, Pérez-Lorensu Pedro Javier, Plata-Bello Julio, Saponaro-González Ángel, Pérez-Orribo Luis, García-Conde Mario, Febles-García Pablo, Roldán-Delgado Héctor, García-Marín Víctor
Аннотация
OBJECTIVE: To evaluate cylindrical depth electrodes in the interhemispheric fissure as an alternative to subdural strip electrodes for direct cortical stimulation (DCS) leg motor evoked potential (MEP) monitoring.
METHODS: A cylindrical depth electrode was positioned in the interhemispheric fissure of 37 patients who underwent supratentorial brain surgery. Leg sensory and motor cortices were localized by highest tibial nerve somatosensory evoked potential amplitude and lowest DCS leg MEP threshold; the lowest-threshold electrode was then used for DCS leg MEP monitoring.
RESULTS: Intraoperative leg MEPs were obtained from all the patients in the series. The mean intensity applied for leg MEP monitoring with the cylindrical depth electrode was 15.2 ± 4.0 mA. No complications secondary to neurophysiological monitoring were detected.
CONCLUSIONS: Lower extremity MEPs were consistently recorded using a multi-contact cylindrical depth electrode in the interhemispheric fissure by DCS.
SIGNIFICANCE: Cylindrical depth electrodes may be a safe and effective alternative for DCS in the interhemispheric fissure, where subdural strips are difficult to place.
METHODS: A cylindrical depth electrode was positioned in the interhemispheric fissure of 37 patients who underwent supratentorial brain surgery. Leg sensory and motor cortices were localized by highest tibial nerve somatosensory evoked potential amplitude and lowest DCS leg MEP threshold; the lowest-threshold electrode was then used for DCS leg MEP monitoring.
RESULTS: Intraoperative leg MEPs were obtained from all the patients in the series. The mean intensity applied for leg MEP monitoring with the cylindrical depth electrode was 15.2 ± 4.0 mA. No complications secondary to neurophysiological monitoring were detected.
CONCLUSIONS: Lower extremity MEPs were consistently recorded using a multi-contact cylindrical depth electrode in the interhemispheric fissure by DCS.
SIGNIFICANCE: Cylindrical depth electrodes may be a safe and effective alternative for DCS in the interhemispheric fissure, where subdural strips are difficult to place.
Предметные рубрики MeSH
AdolescentAdultAgedAnesthesia, IntravenousBrainBrain NeoplasmsElectrodes, ImplantedEquipment DesignEvoked Potentials, MotorEvoked Potentials, SomatosensoryFeasibility StudiesFemaleHumansIntracranial Arteriovenous MalformationsIntraoperative Neurophysiological MonitoringLegMaleMiddle AgedMotor CortexSensory ThresholdsSubdural SpaceTibial NerveTranscranial Direct Current Stimulation