다리에 힘이 없는 환자에서 효과적인 운동 유발전위 파형 측정에 대한 고찰
Effective Motor Evoked Potential Waveforms in Patients with Lower Extremity Weakness
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Motor evoked potential of spinal surgery is known to cause damage due to the movement path ofthe continuous scan operation and surgery can be performed with minimized disability aftersurgery. However, if it is not at all formed at the wave motion evoked potential can occur duringsurgery and, in some cases the size of the waveform to be measured is very small and intermittent. In this case, the surgery cannot provide information about whether there is neurological damage. Increased intensity of the wave-induced motion of the dislocation does not occur if it appears in avery small amplitude stimulus, but changing the inspection area that electrical stimulation of thewaveform changes could not be found. However, stimulation of a wide area in the cerebral cortexwas found to occur with a waveform in the patients who underwent examination. Through thisstudy, we propose a useful motor evoked potential test. From November to December 2015 threespine surgery patients visited Samsung Medical Center as neurosurgery patients with omissiondiscomfort, gait disturbance, and no symptom of strength before surgery. In spine surgery patientswith motor grade weakness, when motor evoked potential waveform has not been measured, inexamination of the site of electrical stimulation of the cerebral cortex from entering theC3+C5/C4+C6 or C3+C1/C4+C2 if by the activity of more motor neuron unit, it was found that thewaveform is better formed.
Abstract
Motor evoked potential of spinal surgery is known to cause damage due to the movement path ofthe continuous scan operation and surgery can be performed with minimized disability aftersurgery. However, if it is not at all formed at the wave motion evoked potential can occur duringsurgery and, in some cases the size of the waveform to be measured is very small and intermittent. In this case, the surgery cannot provide information about whether there is neurological damage. Increased intensity of the wave-induced motion of the dislocation does not occur if it appears in avery small amplitude stimulus, but changing the inspection area that electrical stimulation of thewaveform changes could not be found. However, stimulation of a wide area in the cerebral cortexwas found to occur with a waveform in the patients who underwent examination. Through thisstudy, we propose a useful motor evoked potential test. From November to December 2015 threespine surgery patients visited Samsung Medical Center as neurosurgery patients with omissiondiscomfort, gait disturbance, and no symptom of strength before surgery. In spine surgery patientswith motor grade weakness, when motor evoked potential waveform has not been measured, inexamination of the site of electrical stimulation of the cerebral cortex from entering theC3+C5/C4+C6 or C3+C1/C4+C2 if by the activity of more motor neuron unit, it was found that thewaveform is better formed.
참고문헌 (19)
- Gualtierotti T, "Electrical stimulation of unexposed cerebral cortex", J physiol, 125, pp.278~291 (1954)
- Merton PA, "Electrical stimulation of human motor and visual cortex through the scalp", J Physiol, 305, pp.9~10 (1980)
- Barker T, "Clinical evaluation of conduction time measurements in central motor pathways using magnetic stimulation of human brain", Lancet, 1, pp.1325~1326 (1985)
- Owen JH, "The clinical application of neurogenic motor evoked potentials to monitor spinal cord function during surgery", Spine, 16(8), pp.S391~ (1991)
- Woodforth IJ, "Variability of motor-evoked potentials recorded during nitrous oxide anesthesia from the tibialis anterior muscle after transcranial electrical stimulation", Anesth Analg, 82(4), pp.744~749 (1996)
- Kraft GH, "Somatosensory evoked potentials : clinical uses", Muscle Nerve, 21(2), pp.252~258 (1998)
- Nuwer MR, "Intraoperative neuro physi ologic monitoring", J Clin Neurophysiol, 15(3), pp.181~182 (1998)
- Quiñones-Hinojosa A, "Transcranial motor evoked potentials during basilar artery aneurysm surgery : technique application for 30 consecutive patients", Neurosurgery, 54(4), pp.916~924 (2004)
- Neuloh G, "Monitoring of motor evoked potentials compared with somatosensory evoked potentials and microvascular Doppler ultrasonography in cerebral aneurysm surgery", Journal of neurosurgery, 100(3), pp.389~399 (2004)
- Langeloo DD, "Transcranial electrical motor-evoked potential monitoring during surgery for spinal deformity : a study of 145patients", Spine, 28(10), pp.1043~1050 (2003)
- Weinzierl MR, "Combined motor and somatosensory evoked potentials for intraoperative monitoring : intra-and postoperative data in a series of 69operations", Neurosurg Rev, 30(2), pp.109~116 (2007)
- Costa P, "Somatosensory and motor evoked potential monitoring during spine and spinal cord surgery", Spinal cord, 45(1), pp.86~91 (2007)
- Neuloh G, "Motor evoked potential monitoring for the surgery of brain tumours and vascular malformations", Adv Tech Stand Neurosurg, 29, pp.171~228 (2004)
- 박상구, "수술 중 신경 생리학적인 모니터링의 기본 기술", 대한임상검사과학회지, 45(2), pp.77~85 (2013), 대한임상검사과학회
- 박상구, "수술 중 신경학적인 모니터링과 마취", 대한임상검사과학회지, 44(4), pp.184~198 (2012), 대한임상검사과학회
- Hong JY, "False negative and positive motor evoked potentials in one patient: is single motor evoked potential monitoring reliable method?: a case report and literature review", Spine, 35(18), pp.E912~E916 (2010)
- Ubags LH, "The use of a circumferential cathode improves amplitude of intraoperative electrical transcranial myogenic motor evoked responses", Anesth Analg, 82(5), pp.1011~1014 (1996)
- Journée HL, "Conditioning stimulation techniques for enhancement of transcranially elicited evoked motor responses", Neurophysiol Clin, 37(6), pp.423~430 (2007)
- Szelényi A, "Transcranial electric stimulation for intraoperative motor evoked potential monitoring : stimulation parameters and electrode montages", Clinical neurophysiology, 118(7), pp.1586~1595 (2007)