Limitation of Intraoperative Transcranial Electrical Stimulation-Motor Evoked Potential Monitoring During Brain Tumor Resection Adjacent to the Primary Motor Cortex.
10.5535/arm.2018.42.5.767
- Author:
Hui Jae DO
1
;
Han Gil SEO
;
Byung Mo OH
;
Chul Kee PARK
;
Jin Wook KIM
;
Young Doo CHOI
;
Seung Hak LEE
Author Information
1. Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. seunghak@gmail.com
- Publication Type:Case Report
- Keywords:
Transcranial electrical stimulation;
Direct cortical stimulation;
Intraoperative monitoring
- MeSH:
Axons;
Brain Neoplasms*;
Brain*;
Evoked Potentials*;
Methods;
Monitoring, Intraoperative;
Motor Cortex*;
Muscle Weakness;
Transcranial Direct Current Stimulation
- From:Annals of Rehabilitation Medicine
2018;42(5):767-772
- CountryRepublic of Korea
- Language:English
-
Abstract:
Transcranial electrical stimulation-motor evoked potential (TES-MEP) is a valuable intraoperative monitoring technique during brain tumor surgery. However, TES can stimulate deep subcortical areas located far from the motor cortex. There is a concern about false-negative results from the use of TES-MEP during resection of those tumors adjacent to the primary motor cortex. Our study reports three cases of TES-MEP monitoring with false-negative results due to deep axonal stimulation during brain tumor resection. Although no significant change in TES-MEP was observed during surgery, study subjects experienced muscle weakness after surgery. Deep axonal stimulation of TES could give false-negative results. Therefore, a combined method of TES-MEP and direct cortical stimulation-motor evoked potential (DCS-MEP) or direct subcortical stimulation should be considered to overcome the limitation of TES-MEP.
