Intraoperative Monitoring of Motor-Evoked Potentials for Supratentorial Tumor Surgery.
10.3340/jkns.2014.56.2.98
- Author:
Jung Jae LEE
1
;
Young Il KIM
;
Jae Taek HONG
;
Jae Hoon SUNG
;
Sang Won LEE
;
Seung Ho YANG
Author Information
1. Department of Neurosurgery, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea. 72ysh@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Brain tumor;
Intraoperative monitoring;
Motor-evoked potentials;
Supratentorial;
Surgery
- MeSH:
Brain Neoplasms;
Cooperative Behavior;
Edema;
Evoked Potentials, Motor;
Female;
Hemorrhage;
Humans;
Male;
Monitoring, Intraoperative*;
Paresis;
Supratentorial Neoplasms*;
Vascular System Injuries
- From:Journal of Korean Neurosurgical Society
2014;56(2):98-102
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: The purpose of this study was to assess the feasibility and clinical efficacy of motor evoked potential (MEP) monitoring for supratentorial tumor surgery. METHODS: Between 2010 and 2012, to prevent postoperative motor deterioration, MEP recording after transcranial stimulation was performed in 84 patients with supratentorial brain tumors (45 males, 39 females; age range, 24-80 years; median age, 58 years). MEP monitoring results were correlated with postoperative motor outcome compared to preoperative motor status. RESULTS: MEP recordings were stable in amplitude (<50% reduction in amplitude) during surgery in 77 patients (91.7%). No postoperative motor deficit was found in 66 out of 77 patients with stable MEP amplitudes. However, postoperative paresis developed in 11 patients. False negative findings were associated with edema in peri-resectional regions and postoperative bleeding in the tumor bed. MEP decrease in amplitude (>50%) occurred in seven patients (8.3%). However, no deficit occurred postoperatively in four patients following preventive management during the operation. Three patients had permanent paresis, which could have been associated with vascular injury during tumor resection. CONCLUSIONS: MEP monitoring during supratentorial tumor surgery is feasible and safe. However, false negative MEP results associated with postoperative events may occur in some patients. To achieve successful monitoring, collaboration between surgeon, anesthesiologist and an experienced technician is mandatory.
