A novel threshold criterion in transcranial motor evoked potentials during surgery for gliomas close to the motor pathway

Journal of Neurosurgery
Tammam AbboudTobias Martens

Abstract

OBJECTIVE Warning criteria for monitoring of motor evoked potentials (MEP) after direct cortical stimulation during surgery for supratentorial tumors have been well described. However, little is known about the value of MEP after transcranial electrical stimulation (TES) in predicting postoperative motor deficit when monitoring threshold level. The authors aimed to evaluate the feasibility and value of this method in glioma surgery by using a new approach for interpreting changes in threshold level involving contra- and ipsilateral MEP. METHODS Between November 2013 and December 2014, 93 patients underwent TES-MEP monitoring during resection of gliomas located close to central motor pathways but not involving the primary motor cortex. The MEP were elicited by transcranial repetitive anodal train stimulation. Bilateral MEP were continuously evaluated to assess percentage increase of threshold level (minimum voltage needed to evoke a stable motor response from each of the muscles being monitored) from the baseline set before dural opening. An increase in threshold level on the contralateral side (facial, arm, or leg muscles contralateral to the affected hemisphere) of more than 20% beyond the percentage increase on the ipsilatera...Continue Reading

References

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Citations

Mar 25, 2017·Journal of Neurosurgery·Jose L SanmillanIsabel Fernández-Conejero
Feb 23, 2017·Journal of Neurosurgical Anesthesiology·Jeffrey J Pasternak, William L Lanier
Mar 10, 2018·Journal of Neurosurgical Anesthesiology·Jeffrey J Pasternak, William L Lanier
Jul 7, 2020·Revista española de anestesiología y reanimación·E AldanaUNKNOWN Grupo de Trabajo de la Sección de Neurociencias de la Sociedad Española de Anestesiología y Reanimación (SEDAR) y la Asociac
Jul 3, 2021·Cancers·Evridiki AsimakidouKathleen Seidel

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