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Somatosensory-Evoked Potential Monitoring

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Principles of Neurophysiological Assessment, Mapping, and Monitoring

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Abstract

Somatosensory-evoked potentials (SEPs) are an excellent modality for spinal cord monitoring during surgery. They cover much territory, including the peripheral, spinal, brain stem, thalamic, and cortical levels of sensory pathways. They are used for monitoring for both spinal cord and cerebral injury during various types of surgery.

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References

  1. Nuwer MR. Recording electrode site nomenclature. J Clin Neurophysiol. 1987;4:121–33.

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Author information

Authors and Affiliations

  1. Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    Marc R. Nuwer M.D., Ph.D. & Lara M. Schrader M.D.

  2. Department of Clinical Neurophysiology, Reed Research Building, Room 1-194, 710 Westwood Plaza, Los Angeles, CA, 90095, USA

    Marc R. Nuwer M.D., Ph.D.

  3. Department of Clinical Neurophysiology, Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA

    Pedro Coutin-Churchman M.D., Ph.D.

Authors
  1. Marc R. Nuwer M.D., Ph.D.
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  2. Lara M. Schrader M.D.
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  3. Pedro Coutin-Churchman M.D., Ph.D.
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Corresponding author

Correspondence to Marc R. Nuwer M.D., Ph.D. .

Editor information

Editors and Affiliations

  1. Departments of Anesthesiology and Pharmacology, LSU Health Sciences Center, New Orleans, Louisiana, USA

    Alan David Kaye

  2. Department of Anesthesiology, Louisiana State University School of Medicine, New Orleans, Louisiana, USA

    Scott Francis Davis

Questions and Answers

Questions and Answers

Questions

  1. 1.

    The best trade for SEP stimulation rate is often around

    1. (a)

      3 per second

    2. (b)

      5 per second

    3. (c)

      7 per second

    4. (d)

      9 per second

  2. 2.

    When cortical SEPs are low in amplitude, tactics to improve the signals include

    1. (a)

      Faster stimulation rates

    2. (b)

      Lowering the low filter setting

    3. (c)

      A smaller sample size to produce EPs more quickly

    4. (d)

      Turning on the notch filter

  3. 3.

    In the 10–10 system, electrode site CP2 is located

    1. (a)

      Halfway between Cz and P4

    2. (b)

      Halfway between Cz and C4

    3. (c)

      Halfway between Pz and P4

    4. (d)

      Halfway between C4 and P4

  4. 4.

    The peripheral recording site Erb’s point is at

    1. (a)

      5 cm above the mid-clavicle just lateral to the sternocleidomastoid

    2. (b)

      2 cm above the mid-clavicle just lateral to the sternocleidomastoid

    3. (c)

      Above the clavicle 2 cm lateral to the insertion of the sternocleidomastoid

    4. (d)

      Above the clavicle 5 cm lateral to the insertion of the sternocleidomastoid

  5. 5.

    The most likely location to find the P37 peak for right posterior tibial SEP testing is

    1. (a)

      C1’

    2. (b)

      C2’

    3. (c)

      Cz’

    4. (d)

      CPz

  6. 6.

    Recording site PF is at

    1. (a)

      Posterior frontal

    2. (b)

      Popliteal fossa

    3. (c)

      Parietofrontal

    4. (d)

      Parafrontal

  7. 7.

    Criteria for change in posterior tibial SEPs commonly are

    1. (a)

      10 % amplitude loss or 2 ms latency increase

    2. (b)

      30 % amplitude loss or 3 ms latency increase

    3. (c)

      50 % amplitude loss or 4 ms latency increase

    4. (d)

      70 % amplitude loss or 6 ms latency increase

  8. 8.

    The greatest amplitude decreases in cortical SEPs are commonly associated with

    1. (a)

      Too high a setting of the stimulus intensity

    2. (b)

      Cooling to 32 °C

    3. (c)

      MAC use of inhalation anesthetics

    4. (d)

      Too low of a low filter setting

Answers

  1. 1.

    (b)

  2. 2.

    (b)

  3. 3.

    (a) 

  4. 4.

    (c) 

  5. 5.

    (b)

  6. 6.

     (b)

  7. 7.

     (c)

  8. 8.

    (c)

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Nuwer, M.R., Schrader, L.M., Coutin-Churchman, P. (2014). Somatosensory-Evoked Potential Monitoring. In: Kaye, A., Davis, S. (eds) Principles of Neurophysiological Assessment, Mapping, and Monitoring. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8942-9_6

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  • DOI: https://doi.org/10.1007/978-1-4614-8942-9_6

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-8941-2

  • Online ISBN: 978-1-4614-8942-9

  • eBook Packages: MedicineMedicine (R0)

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