Transcranial motor evoked potential monitoring outcome in the high-risk brain and spine surgeries: Correlation of clinical and neurophysiological data - An Indian perspective

Annals of Indian Academy of Neurology
Poornima Amit Shah

Abstract

The objective of this study is to assess the safety, feasibility and clinical value of transcranial motor evoked potential (MEP) monitoring by electrical stimulation. Clinical neurophysiology department of tertiary reach hospital. MEP monitoring was attempted in 44 "high risk" patients. Intraoperative surgical, anesthesia and neurophysiological findings were documented prospectively. MEP monitoring results were correlated with motor outcome. The success for reliable MEP recording from the lower limbs was 75%. Incidence of new permanent post-operative motor deficit was zero. Nearly, 76.5% of the cases (13 out of 17 cases) who showed unobtainable and unstable MEP outcome had lesion location in the spine as compared with 23.5% (4 out of 17 cases) that had lesion location in the brain. Chi-square test demonstrated a statistically significant difference between these two groups (P = 0.0020). Out of these 13 spine surgery cases, 8 (62%) were operated for deformity. Seven out of 12 (60%) patients less than 12 years of age had a poor MEP monitoring outcome suggesting that extremes of age and presence of a spine deformity may be associated with a lesser incidence of successful MEP monitoring. No complications related to the repetitive t...Continue Reading

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