PMID: 8467425Feb 1, 1993Paper

Penfield Lecture. A quarter century's experience with intraoperative nerve action potential recording

The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques
D G Kline, L T Happel

Abstract

The rationale, basic considerations, and technique of intraoperative nerve action potential (NAP) recording have been reviewed. Experience using this technique in several thousand patients over a 25 year period has been summarized. The most frequent serious nerve injury is one that leaves it in continuity. Resection of such a lesion that is regenerating does the patient a great disservice as does exploration without repair of one with little or no potential for useful spontaneous recovery. The frequency of lesions in continuity as well as the difficulties in evaluating them in the early months by electromyography let alone by surgical inspection has led to the development of intraoperative NAP recording. Where neurolysis was based on a recordable NAP across a lesion in continuity, 93% recovered good function. Where resection of the lesion was based on absence of an NAP, the injury was, without exception, neurotmetic and/or one with poor potential for useful recovery without repair. Some lesions had an NAP across their lesion but a portion of the cross-sectional area appeared more seriously injured. By use of NAP recordings, a split repair was done and usually with good results.

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Citations

Dec 13, 2002·Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society·Neil R Holland
Mar 26, 2003·Journal of Neurosurgery·Lee M BurkholderMarco Vennettilli
Feb 26, 2004·Muscle & Nerve·C Michel Harper
Jan 6, 2006·The Journal of the American Academy of Orthopaedic Surgeons·L Randall Mohler, Douglas P Hanel
Feb 2, 2019·The Journal of the American Academy of Orthopaedic Surgeons·Shelley S NolandAlexander Y Shin
Jun 2, 2000·Neurosurgery·D G Kline
Dec 18, 2001·Muscle & Nerve·J C KingJ J Wertsch
Feb 3, 2006·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Ralph W KönigThomas Kretschmer
Dec 16, 2009·Neurosurgery·Allan H Friedman
Jul 29, 2008·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Mark W KiehnBermans J Iskandar
Jul 15, 2011·Arquivos de neuro-psiquiatria·Mario G Siqueira, Roberto S Martins
Feb 6, 2017·Hand : Official Journal of the American Association for Hand Surgery·Ram K AlluriAlidad Ghiassi
Jul 1, 1996·Neurosurgery·R L TielD G Kline
Oct 13, 2001·Journal of Neurosurgery·D H KimD G Kline
Jun 14, 2003·The Neurologist·Robert E Minahan
Jun 4, 2004·Neurosurgical Focus·Rajiv Midha
Nov 4, 2005·Journal of Neurosurgery·Julia A KandenweinGregor Antoniadis
Nov 1, 1995·Journal of Neurosurgery·D H Kim, D G Kline
Sep 28, 2005·Annals of Plastic Surgery·Ivica DucicEthan E Larson
Dec 5, 2013·Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society·Dinesh G Nair
May 15, 2003·Journal of Neurosurgery·Daniel H KimDavid G Kline
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May 17, 2008·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·William W Campbell
Sep 24, 2021·Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft für Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft für Mikrochirurgie der Peripheren Nerven und Gefässe : Organ der Vereinigung der Deut·Florian Samuel FruehPietro Giovanoli

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