gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Article

Send article

Subcortical mapping of the motor pathways by high-frequency monopolar electrical stimulation

Subkortikales Mapping der motorischen Bahnen durch hochfrequente elektrische Stimulation

Meeting Abstract

Search Medline for

  • corresponding author T. Kombos - Neurochirurgische Klinik; Charité - Universitätsmedizin Berlin, Campus Benjamin-Franklin
  • O. Süss - Neurochirurgische Klinik; Charité - Universitätsmedizin Berlin, Campus Benjamin-Franklin
  • M. Brock - Neurochirurgische Klinik; Charité - Universitätsmedizin Berlin, Campus Benjamin-Franklin

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc10.05.-14.05

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2005/05dgnc0161.shtml

Published: May 4, 2005

© 2005 Kombos et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective

The intraoperative use of neurophysiological techniques allows reliable identification of the sensorimotor region, and constitutes a prerequisite for its anatomical and functional preservation. However, there is no or little experience with subcortical mapping of the motor pathways. The present prospective study uses high-frequency monopolar electrical stimulation (monopolar subcortical stimulation, MSCS) in a protocol for the intraoperative mapping of the subcortical motor pathways.

Methods

Subcortical mapping of the motor pathways by MCS was performed in 23 patients during surgery in and around the motor cortex. Firts cortical motor mapping was performed by cortical stimulation (MCS). During surgery repetitive stimulation of the white substance by MSCS was performed. Compound muscle action potentials (CMAP) were recorded by needle electrodes placed in the muscles of the contralateral extremities. Surgery was performed under general anesthesia without muscle relaxants.

Results

CMAPs were elicited following MCS in 21 and after MSCS in 22 cases. Comparison of the stimulation intensities used by MCS and MSCS revealed no statistical significant difference. MCS was best performed by a train of 5 and a frequency of 400 Hz whereas MSCS was performed by a train of 3 and a frequency of 400 Hz. For MCS a strip electrode with 5 contacts was used. MSCS was performed by a single contact electrode.

Conclusions

Improved surgical safety can be achieved by using intraoperative neurophysiological monitoring techniques. MSCS as performed by high-frequency monopolar electrical stimulation proved to be a reliable method for monitoring subcortical motor pathways.