Application of Compound Action Potential of Facial Muscles Evoked by Transcranial Stimulation as a Reference Waveform of Motor-evoked Potential in Spinal Surgery.

Application of Compound Action Potential of Facial Muscles Evoked by Transcranial Stimulation as a Reference Waveform of Motor-evoked Potential in Spinal Surgery. Hiroshima J Med Sci. 2017 Mar;66(1):1-5 Authors: Morishige M, Takeda M, Yamaguchi S, Sugiyama K, Kurisu K Abstract Transcranial electrical stimulation motor-evoked potential (TES-MEP) has been widely used to monitor major motor pathways in cranial and spinal surgeries. However, the results of TES-MEP might be strongly influenced by anesthetic agents and muscle relaxants. To compensate for this effect, a technique using compound muscle action potentials of the abductor pollicis brevis (APB-CMAP) evoked by median nerve stimulation has recently been reported. In this article, we adopted the transcranial electrical stimulation motor-evoked potential of facial muscles (TES-FMEP) instead of APB-CMAP as a reference waveform for compensation. Intraoperative monitoring in spinal surgeries using TES-MEP, TES-FMEP and APB-CMAP was performed in 64 patients. We compared with and without compensation methods using TES-FMEP and APB-CMAP to evaluate TES-MEP. The cases which demonstrated postoperative motor disturbance, including transient symptoms, were judged to be positive cases. Postoperative transient paraplegia was shown in one intramedullary tumor case among those 64 cases. Compensation by TES-FMEP exhibited the highest specificity (90.5%) and lowest false-positive rate (9.5%) among ...
Source: Hiroshima Journal of Medical Sciences - Category: General Medicine Tags: Hiroshima J Med Sci Source Type: research