Intraoperative clinical neurophysiology : a comprehensive guide to monitoring and mapping

Neurophysiologic intraoperative monitoring (IOM) neurologic monitoring during complex operative procedures is increasingly used to help prevent damage to the nervous system during surgery. Intraoperative Neurophysiology discusses all aspects of IOM with a hands- on approach to this challenging and exciting new frontier.. Everything is covered from set-up, monitoring and mapping, troubleshooting, interpretation of results, and medical management. Interweaving contributions from neurologists and surgeons, the book presents a practical integrated blueprint for effective neurophysiological testing in the operating theater. Intraoperative Neurophysiology is visual and comprehensive in scope and coverage. It begins by reviewing basic neurophysiologic and neuroanatomic knowledge and presents detailed technical information on each basic test, providing the foundation necessary for choosing the right test and customizing monitoring and mapping according to the specifics of individual surgical procedures. Intraoperative Neurophysiology utilizes a unique structure to provide insights into successful monitoring practices and techniques. The book uses the steps of each surgical procedure as the skeleton upon which the IOM procedure is built, thereby presenting a developmental step-by-step approach to IOM procedures and the possible complications and pitfalls - that may arise at different moments of the surgery. In addition, it promotes and encourages the use of EEG in the operating room, and offers unprecedented coverage of ECoG, functional mapping, and EEG monitoring. With over 275 illustrations numerous tables, and the most important clinical points made in writing and exemplified graphically, Intraoperative Neurophysiology: Monitoring and Mapping delivers in words and pictures everything one needs to know to master the art and science of intraoperative neurophysiologic procedure and reduce the operative risk of neurological damage in surgical patients. Contents......Page 8 Preface......Page 12 Acknowledgments......Page 14 Contributors......Page 16 II. Electroencephalogram (EEG)......Page 20 III. Short-latency Somatosensory Evoked Potentials (SSEPs)......Page 24 IV. Motor Evoked Potentials (MEPs)......Page 35 V. Free-Run and Triggered EMG (fEMG and CMAPs)......Page 46 VI. Nerve-to-Nerve or Nerve Action Potentials (NAPs) Recordings......Page 52 VII. Brainstem Auditory Evoked Potentials (BAEPs)......Page 56 VIII. Combinations of Tests......Page 60 IX. Safety Issues......Page 61 References......Page 63 II. Principles of Monitoring CEAs......Page 66 III. Methods......Page 85 IV. Interpretation......Page 91 References......Page 110 II. Historical Perspective......Page 114 III. The Controversial Role of ECoG in Epilepsy Surgery......Page 115 IV. Indications......Page 117 V. Methodology......Page 134 VI. Interpretation......Page 136 VII. Anesthesia Considerations......Page 143 References......Page 146 I. Introduction......Page 150 II. Surgical Preparation......Page 151 III. Sensorimotor Mapping......Page 152 IV. Language Mapping......Page 168 V. Cortical Mapping Threshold Variability......Page 174 VI. ECoG During Functional Mapping......Page 176 References......Page 192 II. The Role of Intraoperative Neurophysiology......Page 196 III. A Historical Perspective......Page 197 IV. Intraoperative Neurophysiologic Monitoring......Page 198 References......Page 226 I. Introduction......Page 228 II. Intraoperative Neurophysiologic Monitoring: A Step-By-Step Approach......Page 229 References......Page 239 I. Introduction......Page 242 III. The Nuts and Bolts of Deformity Surgery......Page 243 IV. The Role of Intraoperative Neurophysiology......Page 244 V. Intraoperative Neurophysiologic Monitoring: A Step-By-Step Approach......Page 245 References......Page 253 I. Introduction......Page 256 II. The Vascularization of the Spinal Cord......Page 257 III. Operative Techniques: Preventing Acute Spinal Cord Ischemia......Page 259 IV. Delayed Neurologic Events and Surgical Outcomes......Page 280 V. Conclusion......Page 281 References......Page 282 I. Introduction......Page 286 II. Surgery at the Level of the Cauda Equina and Nerve Root......Page 287 III. Nerve Tumor Surgery......Page 298 IV. Never Injury Surgery......Page 303 References......Page 316 I. Introduction......Page 318 II. Midbrain......Page 320 III. Pons......Page 322 IV. Medulla......Page 336 References......Page 340 II. Benzodiazepines......Page 344 IV. Propofol......Page 345 V. Narcotics......Page 346 VI. Inhalational Agents......Page 347 VIII. Ketamine......Page 348 X. Muscle Relaxants......Page 349 References......Page 351 A......Page 354 C......Page 355 E......Page 357 F......Page 359 M......Page 360 N......Page 361 P......Page 362 S......Page 363 T......Page 366 U......Page 367 Y......Page 368 "Neurophysiologic intraoperative monitoring (IOM) neurologic monitoring during complex operative procedures is increasingly used to help prevent damage to the nervous system during surgery. Intraoperative Neurophysiology discusses all aspects of IOM with a hands- on approach to this challenging and exciting new frontier. Everything is covered from set-up, monitoring and mapping, troubleshooting, interpretation of results, and medical management. Interweaving contributions from neurologists and surgeons, the book presents a practical integrated blueprint for effective neurophysiological testing in the operating theater. Intraoperative Neurophysiology is visual and comprehensive in scope and coverage. It begins by reviewing basic neurophysiologic and neuroanatomic knowledge and presents detailed technical information on each basic test, providing the foundation necessary for choosing the right test and customizing monitoring and mapping according to the specifics of individual surgical procedures. Intraoperative Neurophysiology utilizes a unique structure to provide insights into successful monitoring practices and techniques. The book uses the steps of each surgical procedure as the skeleton upon which the IOM procedure is built, thereby presenting a developmental step-by-step approach to IOM procedures and the possible complications and pitfalls - that may arise at different moments of the surgery. In addition, it promotes and encourages the use of EEG in the operating room, and offers unprecedented coverage of ECoG, functional mapping, and EEG monitoring. With over 275 illustrations, numerous tables, and the most important clinical points made in writing and exemplified graphically, Intraoperative Monitoring and Mapping delivers in words and pictures everything one needs to know to master the art and science of intraoperative neurophysiologic procedure and reduce the operative risk of neurological damage in surgical patients. " Neurophysiologic intraoperative monitoring (IOM) is increasingly used to help prevent damage to the nervous system during surgery. This text discusses all aspects of IOM with a hands- on approach to this challenging and exciting new frontier. Everything is covered from set-up, monitoring and mapping, troubleshooting, interpretation of results, and medical management. Interweaving contributions from neurologists and surgeons, the book presents a practical integrated blueprint for effective neurophysiological testing in the operating theater. With over 275 illustrations, numerous tables, and the most important clinical points made in writing and exemplified graphically, this book delivers in words and pictures everything one needs to know to master the art and science of intraoperative neurophysiologic procedure and reduce the operative risk of neurological damage in surgical patients Neurophysiologic tests used in the operating room / Mirela V. Simon EEG monitoring during carotid endarterectomy / Mirela V. Simon and Keith H. Chiappa Electrocorticography / Mirela V. Simon, Jason L. Gerrard, and Emad N. Eskandar Functional cortical mapping / Mirela V. Simon, Donald C. Shields, and Emad N. Eskandar Intraoperative neurophysiologic monitoring and mapping of the spinal cord / Mirela V. Simon ... [et al.] Peripheral nerve surgery / Jean-Valerie C.E. Coumans ... [et al.] Intraoperative neurophysiologic monitoring of the cranial nerves and brainstem / Wael F. Asaad, Mirela V. Simon, and Emad N. Eskandar The effects of anesthetics on intraoperative neurophysiology studies / Mirela V. Simon.