Cannabinoid-induced alteration of motor-evoked potentials (MEPs) prior to intradural spinal tumor removal: a nasty surprise
The morbidity related to intradural spinal tumor resection was reduced in the last years thanks to the recent advances in microsurgical techniques and the addition of intraoperative monitoring (IOM) .
Motor-evoked potentials (MEPs) and D-wave are generally coupled with continuous electromyography (EMG) to permit safe resection of spinal tumors .
Nevertheless, intraoperative MEPs may be altered due to previous intradural surgeries or concomitant pharmacological interactions .
Here, we present an interesting case of early operative MEPs alteration probably secondary to preoperative cannabinoid treatment.
A 12-year-old girl with neurofibromatosis type 1 suffered from a multi metastatic, resected posterior fossa ependymoma. She was previously operated for a C3-C6 intramedullary metastasis (WHO grade III ependymoma), followed by craniospinal radiotherapy. Motor-evoked potentials were preserved on upper limbs and present but delayed on both lower limb tibialis anterior...
We heartily thank Madame Sandra Abreu-Duarte, nurse practitioner in neurophysiology at the CHUV, for the qualified collaboration during intraoperative neuromonitoring.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.