Electrophysiologic Monitoring of Neural Function during Surgery

  • Jasper R. Daube
Part of the Topics in Neurosurgery book series (TINS, volume 2)


Electrophysiologic monitoring has provided surgeons direct and immediate feedback about the function of neural structures that may be inadvertently damaged during surgery. The value of these techniques in many different types of surgery is just being realized, as the full range of electrophysiologic monitoring is applied. Many different electrical measures of neural function have been applied, and most have been found to be useful measures of neural function under anesthesia.


Facial Nerve Motor Evoke Potential Neural Function Compound Muscle Action Potential Somatosensory Evoke Potential 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Allen A, Starr A and Nudleman K: Assessment of sensory function in the operating room utilizing cerebral evoked potentials: A study of fifty-six surgically anesthesized patients. Clin Neurosurg 28:457–481, 1981.PubMedGoogle Scholar
  2. 2.
    Bennett M: Effects of compression and ischemia on spinal cord evoked potentials. Exp Neurol 80:508–519, 1983.PubMedCrossRefGoogle Scholar
  3. 3.
    Berenstein Young W, Ransohoff J et al.: Somatosensory evoked potentials during spinal angiography and therapeutic transvascular embolization. J Neurosurg 60:777–785, 1984.PubMedCrossRefGoogle Scholar
  4. 4.
    Boston JR: Algorithm for monitoring sensory evoked potentials. J Clin Monitoring 1:201- 206, 1985.CrossRefGoogle Scholar
  5. 5.
    Boyd SG et al.: Method of monitoring function in corticospinal pathways during scoliosis surgery. J Neurol Neurosurg Psychiat 49:251–257, 1986.PubMedCrossRefGoogle Scholar
  6. 6.
    Delgado TE, Buchheit WA, Rosenholtz HR et al.: Intraoperative monitoring of facial muscle evoked responses obtained by intracranial stimulation of the facial nerve. Neurosurg 418–420, 1979.Google Scholar
  7. 7.
    Dinner D, Lueders H, Lesser R and Morris R: Invasive methods of somatosensory evoked potential monitoring. J Clin Neurophysiol 3:113–130, 1986.PubMedCrossRefGoogle Scholar
  8. 8.
    Engler G et al.: SEP monitoring during Harrington instrumentation for scoliosis. J Bone Joint Surg 60-A:528–532, 1978.PubMedGoogle Scholar
  9. 9.
    Erickson DL, Ausman JI and Chou S: Prognosis of seventh nerve palsy following removal of large acoustic tumors. J Neurosurg 47:3134, 1977.Google Scholar
  10. 10.
    Friedman WA, Kaplan BJ, Gravenstein D and Rhoton Jr, AL: Intraoperative brain-stem auditory evoked potentials during posterior fossa microvascular decompression. J Neurosurg 62:552–557, 1985.PubMedCrossRefGoogle Scholar
  11. 11.
    Grundy BL, Jannetta PJ, Lina A, Procopio P, Boston JR and Doyle E: Intraoperative monitoring of brainstem auditory evoked potentials. J Neurosurg 57:674–677, 1981.Google Scholar
  12. 12.
    Grundy B et al.: Intraoperative loss of somatosensory evoked potentials loss of spinal cord function. Anesth 57:321, 1982.CrossRefGoogle Scholar
  13. 13.
    Hall J et al.: Intraoperative awakening to monitor spinal cord function. J Bone Joint Surg 60-A:533–536, 1978.PubMedGoogle Scholar
  14. 14.
    Harner S, Daube JR, Ebersold M: Electrophysiologic monitoring of neural function during acoustic neurinoma surgery, (submitted)Google Scholar
  15. 15.
    Harner S and Laws E: Posterior fossa approach for removal of acoustic neurinomas. Arch Otolaryngol 107:509–593, 1981.Google Scholar
  16. 16.
    Harner S and Laws E: Diagnosis of acoustic neurinoma. Neurosurg 9:373–379, 1981.CrossRefGoogle Scholar
  17. 17.
    Harner S and Laws E: Clinical findings in patients with acoustic neurinoma. Mayo Clin Proc 58:721–728, 1983.PubMedGoogle Scholar
  18. 18.
    Harner S, Daube JR and Ebersold M: Electrophysiologic monitoring during temporal bone surgery. Laryngoscope 96:65–69, 1986.PubMedCrossRefGoogle Scholar
  19. 19.
    House WF and Luetje CM (eds): Acoustic Tumors. Baltimore, University Park Press, 1979.Google Scholar
  20. 20.
    Jones et al.: Sensory nerve conduction in human spinal cord. J Neurol Neurosurg Pyschiat 45:446–451, 1982.CrossRefGoogle Scholar
  21. 21.
    Jones SJ, Carter L et al.: Experience of epidural spinal cord monitoring in 410 cases. In: J Schramm and S Jones (eds): Spinal Cord Monitoring. Springer, Berlin, 1985.Google Scholar
  22. 22.
    Kimura J: Electrodiagnosis in Diseases of Nerve and Muscle. FA Davis, 1983.Google Scholar
  23. 23.
    Kimura J and Lyon L: Alteration of orbicularis oculi reflex by posterior fossa tumors. J Neurosurg 38:10, 1973.PubMedCrossRefGoogle Scholar
  24. 24.
    Kline DG, Hackett ER and Happel LH: Surgery for lesions of the brachial plexus. Arch Neurol, 43:170–181, 1986.PubMedCrossRefGoogle Scholar
  25. 25.
    Laschinger JC, Cunningham Jr, JN, Isom W et al.: Definition of the safe lower limits of aortic resection during surgical procedures on the thoracoabdominal aorta: Use of somatosensory evoked potentials. JACC 2:959–965, 1983.PubMedGoogle Scholar
  26. 26.
    Lesser RP, Lueders H, Dinner DS et al.: Technical aspects of surgical monitoring using evoked potentials. In: A Struppler and A Weindel:Electromyography and Evoked Potentials. Springer-Verlag, 1985, 177–180.Google Scholar
  27. 27.
    Lesser RP et al.: Postoperative neruological deficits may occur despite unchanged intraoperative SEP. Ann Neurol 19:22–25, 1986.PubMedCrossRefGoogle Scholar
  28. 28.
    Levine RA, Ojemann RG, Montgomery WW and MCGaffigan PM: Monitoring auditory evoked potentials during acoustic neuroma surgery: Insights into the mechanism of the hearing loss. Ann Otol Rhinol Laryngol 93:116–123, 1984.PubMedGoogle Scholar
  29. 29.
    Levy WJ, York DH, McCaffrey M and Tanzer F: Motor evoked potentials from transcranial stimulation of the motor cortex in humans. Neurosurg 15:287–302, 1984.CrossRefGoogle Scholar
  30. 30.
    Lueders H et al.: New techniques for intraoperative monitoring of spinal cord function. Spine 7:110–115, 1982.PubMedCrossRefGoogle Scholar
  31. 31.
    Macon J and Poletti: Conducted SEP during surgery. J Neurosurg, 57:349–359, 1982.PubMedCrossRefGoogle Scholar
  32. 32.
    Mahla ME, Long DM, McKennett J et al.: Detection of brachial plexus dysfunction by somatosensory evoked potential monitoring—A report of two cases. Anesthesiol 60:248–252, 1984.CrossRefGoogle Scholar
  33. 33.
    McPherson RW, Niedermeyer EF, Otenasek RJ and Hanley DF: Correlation of transient neurological deficit and somatosensory evoked potentials after intracranial aneurysm surgery. J Neurosurg 59:146–149, 1983.PubMedCrossRefGoogle Scholar
  34. 34.
    Mills KR and Murray NM: Corticospinal tract conduction time in multiple sclerosis. Ann Neurol 18:601–605, 1985.PubMedCrossRefGoogle Scholar
  35. 35.
    Mizrahi EM and Crawford ES: Somatosensory evoked potentials during reversible spinal cord ischemia in man. EEG Clin Neurophysiol 58:120–126, 1984.CrossRefGoogle Scholar
  36. 36.
    Moller AR and Jannetta PJ: Monitoring auditory functions during cranial nerve microvascular decompression by direct recording from the eighth nerve. J Neurosurg 59:493–499, 1983.PubMedCrossRefGoogle Scholar
  37. 37.
    Moller AR andjannetta PJ: Preservation of facial function during removal of acoustic neuromas. Use of monopolar constant-voltage stimulation and EMG. J Neurosurg 61:757–760, 1984.PubMedCrossRefGoogle Scholar
  38. 38.
    Moller AR and Jannetta PJ: Microvascular decompression in hemifacial spasm. Neurosurg 16:612–618, 1985.CrossRefGoogle Scholar
  39. 39.
    Nash et al.: Spinal cord monitoring during operative treatment of the spine. Clin Orthoped 126:100–105, 1977.Google Scholar
  40. 40.
    Ojemann RG, Levine RA, Montgomery WM and McGaffigan BA: Use of intraoperative auditory evoked potentials to preserve hearing in unilateral acoustic neuroma removal. J Neurosurg 61:938–948, 1984.PubMedCrossRefGoogle Scholar
  41. 41.
    Piatt Jr JH, Radtke RA and Erwin CW: Limitations of brain stem auditory evoked potentials for intraoperative monitoring during a posterior fossa operation: Case report and technical note. Neurosurg 16:818–821, 1985.CrossRefGoogle Scholar
  42. 42.
    Raman RT, Reddy and Rao SV: Orbicularis oculi reflex and facial muscle electromyography. J Neurosurg 44:550–555, 1976.PubMedCrossRefGoogle Scholar
  43. 43.
    Raudzens PA and Shetter AG: Intraoperative monitoring of brain-stem auditory evoked potentials. J Neurosurg 57:341–348, 1982.PubMedCrossRefGoogle Scholar
  44. 44.
    Raudzens P: Intraoperative SEPs. Anesth 58:593–594, 1983.CrossRefGoogle Scholar
  45. 45.
    Rhotonjr, AL: Microsurgical removal of acoustic neuromas. Surg Neurol 6:211–219, 1976.Google Scholar
  46. 46.
    Rossi B, Buonaguidi A and Tusini G: Blink reflexes in posterior fossa lesions. J Neurol Neurosurg Psychiat 42:465–469, 1979.PubMedCrossRefGoogle Scholar
  47. 47.
    Sgro JA, Emerson RG and pedley TA: Real-time reconstruction of evoked potentials using two-dimensional filter. EEG Clin Neurophysiol 62:372–380, 1985.Google Scholar
  48. 48.
    Sugioka H: Evoked potentials in the investigation of traumatic lesions of the peripheral nerve and the brachial plexus. Clin Orthoped Rel Res 184:85–92, 1984.Google Scholar
  49. 49.
    Sugita K, Kobayashi S, Matsuga N and Suziki Y: Microsurgery for acoustic neurinoma— lateral position and preservation of facial and cochlear nerves. Neurol Med Chir (Tokyo) 19:637–641, 1979.CrossRefGoogle Scholar
  50. 50.
    Symon L, Wang AD, Costae Silva IE and Gentih F: Perioperative use of somatosensory evoked responses in aneurysm surgery. J Neurosurg 60:269–275, 1984.PubMedCrossRefGoogle Scholar
  51. 51.
    Tamaka T et al.: Prevention of iatrogenic spinal cord injury utilizing evoked spinal cord potential. Int Orthoped 4:313–317, 1981.Google Scholar
  52. 52.
    Wang AD, Cone J, Symon L and Costa e Silva IE: Somatosensory evoked potential monitoring during the management of aneurysmal SAH. J Neurosurg 60:264–268, 1984.PubMedCrossRefGoogle Scholar
  53. 53.
    Worth R et al.: Intraoperative SEP monitoring during spinal cord surgery. In: J Courgon (ed): Clinical Applications of Evoked Potentials in Neurology. Raven Press, 367–373, 1982.Google Scholar

Copyright information

© Kluwer Academic Publishers, Boston 1989

Authors and Affiliations

  • Jasper R. Daube

There are no affiliations available

Personalised recommendations