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KMID : 1140920180420050767
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Annals of Rehabilitation Medicine
2018 Volume.42 No. 5 p.767 ~ p.772
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Limitation of Intraoperative Transcranial Electrical Stimulation-Motor Evoked Potential Monitoring During Brain Tumor Resection Adjacent to the Primary Motor Cortex
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Do Hui-Jae
Seo Han-Gil
Oh Byung-Mo
Park Chul-Kee
Kim Jin-Wook
Choi Young-Doo
Lee Seung-Hak
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Abstract
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Transcranial electrical stimulation-motor evoked potential (TES-MEP) is a valuable intraoperative monitoring technique during brain tumor surgery. However, TES can stimulate deep subcortical areas located far from the motor cortex. There is a concern about false-negative results from the use of TES-MEP during resection of those tumors adjacent to the primary motor cortex. Our study reports three cases of TES-MEP monitoring with false-negative results due to deep axonal stimulation during brain tumor resection. Although no significant change in TES-MEP was observed during surgery, study subjects experienced muscle weakness after surgery. Deep axonal stimulation of TES could give false-negative results. Therefore, a combined method of TES-MEP and direct cortical stimulation-motor evoked potential (DCS-MEP) or direct subcortical stimulation should be considered to overcome the limitation of TES-MEP.
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KEYWORD
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Transcranial electrical stimulation, Direct cortical stimulation, Intraoperative monitoring
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