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Journal of Clinical Monitoring and Computing

, Volume 20, Issue 5, pp 347–377 | Cite as

Intraoperative Motor Evoked Potential Monitoring: Overview and Update

  • David B. MacDonaldEmail author
Specialty Section on Surgical Neuromonitoring

Abstract

Amidst controversy about methodology and safety, intraoperative neurophysiology has entered a new era of increasingly routine transcranial and direct electrical brain stimulation for motor evoked potential (MEP) monitoring. Based on literature review and illustrative clinical experience, this tutorial aims to present a balanced overview for experienced practitioners, surgeons and anesthesiologists as well as those new to the field. It details the physiologic basis, indications and methodology of current MEP monitoring techniques, evaluates their safety, explores interpretive controversies and outlines some applications and results, including aortic aneurysm, intramedullary spinal cord tumor, spinal deformity, posterior fossa tumor, intracranial aneurysm and peri-rolandic brain surgeries. The many advances in motor system assessment achieved in the last two decades undoubtedly improve monitoring efficacy without unduly compromising safety. Future studies and experience will likely clarify existing controversies and bring further advances.

Key Words

transcranial electrical motor evoked potential intraoperative neurophysiology aortic aneurysm intramedullary spinal cord tumor posterior fossa tumor intracranial aneurysm peri-rolandic brain surgery 

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Copyright information

© Springer Science + Business Media, Inc. 2006

Authors and Affiliations

  1. 1.Department of NeurosciencesKing Faisal Specialist Hospital & Research CenterRiyadhSaudi Arabia

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