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INTRAOPERATIVE LOCALIZATION OF CORTICAL MOTOR EVOKED POTENTIALS IN CENTRAL SULCUS LESIONS
Authors:FEI Zhi-min  DING Zhao-qi  ZHANG Jue  CUI Hua  LI Xue-ming  ZHOU Cai-fang  SHU Guo-wei  ZHOU Zheng-wen  WANG Yong
Institution:FEI Zhi-min(Department of Neurosurgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200001, China);DING Zhao-qi(Department of Neurosurgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200001, China);ZHANG Jue(Department of Neurosurgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200001, China);CUI Hua(Department of Neurosurgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200001, China);LI Xue-ming(Department of Neurosurgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200001, China);ZHOU Cai-fang(Department of Neurosurgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200001, China);SHU Guo-wei(Department of Neurosurgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200001, China);ZHOU Zheng-wen(Department of Neurosurgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200001, China);WANG Yong(Department of Neurosurgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200001, China);
Abstract:Objective To study direct cortical electrical stimulation technique for the recording of motor evoked potentials under general anesthesia in central sulcus lesions. Methods The largest N20-P25 response was recorded from postcentral gyrus by intraoperative monitoring of cortical motor evoked potentials in 10 patients with intracranial lesions near or in the central area. The muscles of upper extremity in all patients were activated by delivering stimulus to cortical areas continuously. Moving the cortical electrodes forward, the largest P20-N25 response, SEP phase reversal,was obtained as a motor center stimulus. In this site of cortex, a short train stimulation elicited reproducible muscle action potentials that could be observed from the oscilloscope without averaging.Results MEPs can be recorded, pre- and post-operatively, without motor deficits of upper limbs in all patients.Conclusion This technique seems to be preferable for intraoperative localization of motor evoked potentials in central sulcus lesions under total intravenous anesthesia.
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