12. Median SSEPs phase reversal technique

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• 作者：Mirela Simon
• 刊名：Clinical Neurophysiology
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：127
• 期：9
• 页码：e306
• 全文大小：32 K

文摘

In this presentation, I will give an overview of the principle, methodology, interpretation and troubleshooting of this neurophysiologic technique used in cortical sensorimotor mapping and monitoring during supratentorial surgery. I will show multiple examples of recordings and how important information can be extracted from these recordings even in the absence of a phase reversal. I will then go over the main causes of uninformative recordings, such as anesthetic effects, suboptimal location of the recording electrodes, brain pathology, or technical reasons. I will give examples of how inter-individual variability of morphology, amplitudes and latencies of median SSEPs play a significant role in accurate interpretation of these recordings, and thus in accurate localization of the central sulcus(CS) and sensorimotor cortex and why, in spite of its challenging methodology and interpretation, it is important to use it together with cortical electrical stimulation. I will conclude with a case presentation: I will first show how different information extracted from the patient’s history/clinical presentation/neuroimaging becomes relevant to the intraoperative recordings; I will then conclude with images of SSEPs recordings from the same case and how their interpretation helps with CS localization in the absence of phase reversal.