Summary
During percutaneous cordotomy, impedance monitoring and electric stimulation have been widely used to enable a precise localization of the lesion electrode. The purpose of this study was to examine the possibility that the usage of additional electrophysiological techniques could help in improving the precision of the placement of the lesion electrode.
Fourteen patients were monitored with 4 different techniques during CT-guided percutaneous cordotomy
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1)
Median nerve somatosensory evoked potentials (mSEP): median nerve stimulation with recording from the scalp.
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2)
Spinal cord evoked potentials (SCEP): median nerve stimulation with recording via the cordotomy electrode.
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3)
Spinothalamic evoked potentials (SthEP): stimulation via the cordotomy electrode and recording from the scalp.
Ipsilateral and contralateral mSEPs and SCEPs did not change after the lesion. SthEPs showed a significant decrease in 10 of 12 patients provided the stimulus intensity was kept below that producing a motor response (approx 0.5-1 mA). There was no obvious relationship between changes of the evoked potentials and the clinical outcome of the cordotomy. Our results suggest that there may be a relationship between the extent of the lesion and the decrease of the spinothalamic evoked potentials.
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References
Amano K, Kawabatake H, Miyazaki T, Iseki H, Notani M, Kawamura H, Kitamura K (1978) Percutaneous cervical cordotomy and cerebral evoked response. Pain Abstracts, 2nd World Congress on Pain of the Int Study of Pain, Montreal, Vol 1, pp 106
Campbell J A, Lipton S (1984) Intraspinal evoked potentials in man during cervical cordotomy. In: Homma S, Tamaki T (eds) Fundamentals and clinical application of spinal cord monitoring. Saikon, Tokyo, pp 245–252
Ertekin C, Sanca Y, Üçkardeşler L (1983) Studies on the human spontaneous electromyelogram (EMyeloG) I. Normal subjects. Electroenceph Clin Neurophysiol 55: 13–23
Ertekin C, Sanca Y, Üçkardeşler L (1984) Somatosensory cerebral potentials evoked by stimulation of the lumbosacral spinal cord in normal subjects and in patients with conus medullaris and cauda equina lesions. Electroenceph Clin Neurophysiol 59: 57–66
Hitchcock E, Lewin M (1969) Stereotactic recording from the spinal cord of man. BMJ 4: 44–45
Iseki H, Amano K, Kawamura H, Tanikawa T, Kawabatake H, Notani M, Shiwaku T, Kitamura K (1982) Somatotopic arrangement of lateral spinothalamic tract in percutaneous cervical cordotomy. Proc 8th Meeting World Soc Stereotactic and Functional Neurosurgery, Part III, Zurich 1981. Appl Neuro- physiol 45: 484–491
Kanpolat Y, Deda H, Akyar S, Bilgig S (1989) CT-guided percutaneous cordotomy. Acta Neurochir (Wien) 46: 61–68
Taira T, Amano K, Kawamura H, Tanikawa T, Kitamura K (1985) Cerebral-evoked responses elicited by direct stimulation of the lateral spinothalamic tract in the human. Appl Neurophysiol 48: 267–270
Taren J A, Davis R, Crosby EC (1969) Target physiologic correlation in stereotaxic cervical cordotomy. J Neurosurg 30: 569–584
Tasker RR, Organ LW (1973) Percutaneous cordotomy-physiologic identification of target site. Confin Neurol 35: 110–117
Yegül I, Uyar M, Ulukaya S (1994) CT guided percutaneous cordotomy. Proc 6th Intern Congr Pain Clinics, April 15–20, pp 138
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© 1995 Springer-Verlag
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Zileli, M., Coşkun, E., Yegül, I., Uyar, M. (1995). Electrophysiological Monitoring During CT-Guided Percutaneous Cordotomy. In: Meyerson, B.A., Ostertag, C. (eds) Advances in Stereotactic and Functional Neurosurgery 11. Acta Neurochirurgica Supplementum, vol 64. Springer, Vienna. https://doi.org/10.1007/978-3-7091-9419-5_20
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DOI: https://doi.org/10.1007/978-3-7091-9419-5_20
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