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Direct cortical stimulation with cylindrical depth electrodes in the interhemispheric fissure for leg motor evoked potential monitoring |
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| Institution: | 1. Department of Neurosurgery, Stanford University School of Medicine, United States of America;2. Department of Neurology, Stanford University School of Medicine, United States of America;3. Division of Pediatric Neurology, Lucile Packard Children''s Hospital Stanford, United States of America;4. Division of Pediatric Neurosurgery, Lucile Packard Children''s Hospital Stanford, United States of America;1. Department of Epileptology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany;2. Faculty of Psychology, Swiss Distance University Institute, Ueberlandstr. 12, 3900 Brig, Switzerland;3. Department of Neurosurgery, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany;4. School of Psychology & Centre for Human Brain Health, University of Birmingham, Birmingham, B15 2TT, United Kingdom;1. Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe-University, Frankfurt am Main, Germany;2. Department of Neurosurgery, Goethe-University, Frankfurt am Main, Germany;3. Department of Neuroradiology, Goethe-University, Frankfurt am Main, Germany;4. Department of Neuropediatrics, Goethe-University, Frankfurt am Main, Germany;5. LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University, Frankfurt am Main, Germany |
| Abstract: | ObjectiveTo evaluate cylindrical depth electrodes in the interhemispheric fissure as an alternative to subdural strip electrodes for direct cortical stimulation (DCS) leg motor evoked potential (MEP) monitoring.MethodsA cylindrical depth electrode was positioned in the interhemispheric fissure of 37 patients who underwent supratentorial brain surgery. Leg sensory and motor cortices were localized by highest tibial nerve somatosensory evoked potential amplitude and lowest DCS leg MEP threshold; the lowest-threshold electrode was then used for DCS leg MEP monitoring.ResultsIntraoperative leg MEPs were obtained from all the patients in the series. The mean intensity applied for leg MEP monitoring with the cylindrical depth electrode was 15.2 ± 4.0 mA. No complications secondary to neurophysiological monitoring were detected.ConclusionsLower extremity MEPs were consistently recorded using a multi-contact cylindrical depth electrode in the interhemispheric fissure by DCS.SignificanceCylindrical depth electrodes may be a safe and effective alternative for DCS in the interhemispheric fissure, where subdural strips are difficult to place. |
| Keywords: | Intra-operative monitoring Direct cortical stimulation Motor evoked potentials Leg Multi-contact cylindrical depth electrode |
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