Methodology for intraoperatively eliciting motor evoked potentials in the vocal muscles by electrical stimulation of the corticobulbar tract
Abstract
To establish a methodology for recording corticobulbar motor evoked potentials (CoMEPs) from vocal muscles after transcranial electrical stimulation (TES) and direct cortical stimulation (DCS). Twenty-four patients were included in this study (22 for TES, 2 for DCS, 3 for TES plus DCS) that underwent different surgical procedures. We used two methods to elicit CoMEPs: (a) TES by stimulation over C3/Cz or C4/Cz and (b) DCS with a strip electrode placed over the primary motor area (M1) for laryngeal muscles. To record CoMEPs from vocal muscles we used two hook wire electrodes 76 microm of diameter passing through 27 gauge needle endotracheally placed in the vocal muscles after intubation. Recording of CoMEPs in the vocal muscles after TES was successfully performed in 22 patients. TES over the right or left hemisphere elicit responses bilaterally. The onset latencies for the right vocal muscle was 12.4+/-3.1 ms (ipsilateral stimulation) and 12.7+/-2.2 ms (contralateral stimulation) while for the left vocal muscle, onset latency was 12.9+/-2.3 ms (ipsilateral stimulation) and 14.1+/-3.4 ms (contralateral stimulation). In five patients DCS elicited CoMEPs in right and left vocal muscle with latency of 16.6+/-4.7 and 15.6+/-3.7 ms, ...Continue Reading
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Intra-operative monitoring of lower extremity motor-evoked potentials by direct cortical stimulation
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