Pub Date : 2015-02-10DOI: 10.1080/00029238.1980.11080011
T. Riley, H. Berndt
{"title":"The Role of the EEG Technologist in Delineating Pseudoseizures","authors":"T. Riley, H. Berndt","doi":"10.1080/00029238.1980.11080011","DOIUrl":"https://doi.org/10.1080/00029238.1980.11080011","url":null,"abstract":"","PeriodicalId":7480,"journal":{"name":"American Journal of Electroneurodiagnostic Technology","volume":"104 1","pages":"89-96"},"PeriodicalIF":0.0,"publicationDate":"2015-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75289389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-12-01DOI: 10.1080/1086508X.2011.11079829
S. Davis, M. Khalek, J. Giles, C. Fox, L. Lirette, E. Kandil
ABSTRACT. Robotic assisted surgery is becoming widely used for procedures such as radical prostatectomy. The use of robotic assisted surgery to perform partial and complete thyroidectomies using a transaxillary approach is being investigated in patient populations who wish to avoid a conspicuous cervical scar. Patient positioning for this approach as well as retraction during exposure has the potential to result in postoperative brachial plexopathy similar to what is seen in other types of surgery. We report the use of ulnar nerve somatosensory evoked potentials (SSEPs) to detect and prevent positional related neuropathy in the first pediatric patient in the world to undergo this procedure. We conclude that upper extremity SSEPs should be routinely performed during robotic assisted thyroidectomy.
{"title":"Detection and Prevention of Impending Brachial Plexus Injury Secondary to Arm Positioning Using Ulnar Nerve Somatosensory Evoked Potentials During Transaxillary Approach for Thyroid Lobectomy","authors":"S. Davis, M. Khalek, J. Giles, C. Fox, L. Lirette, E. Kandil","doi":"10.1080/1086508X.2011.11079829","DOIUrl":"https://doi.org/10.1080/1086508X.2011.11079829","url":null,"abstract":"ABSTRACT. Robotic assisted surgery is becoming widely used for procedures such as radical prostatectomy. The use of robotic assisted surgery to perform partial and complete thyroidectomies using a transaxillary approach is being investigated in patient populations who wish to avoid a conspicuous cervical scar. Patient positioning for this approach as well as retraction during exposure has the potential to result in postoperative brachial plexopathy similar to what is seen in other types of surgery. We report the use of ulnar nerve somatosensory evoked potentials (SSEPs) to detect and prevent positional related neuropathy in the first pediatric patient in the world to undergo this procedure. We conclude that upper extremity SSEPs should be routinely performed during robotic assisted thyroidectomy.","PeriodicalId":7480,"journal":{"name":"American Journal of Electroneurodiagnostic Technology","volume":"31 1","pages":"274 - 279"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87524235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-12-01DOI: 10.1080/1086508X.2011.11079827
Matthew R. Eager, Adam L. Shimer, F. Jahangiri, F. Shen, V. Arlet
ABSTRACT. Intraoperative neurophysiological monitoring (IONM) is becoming the standard of care for many spinal surgeries, especially those with deformity correction and instrumentation. We reviewed 2069 spine cases with multimodality IONM including somatosensory evoked potentials (SSEP), transcranial electrical motor evoked potentials (TCeMEP), and spontaneous and triggered electromyography (s-EMG and t-EMG) in a University setting over a period of four years to examine perioperative clinical findings when an IONM event was noted and to ascertain how IONM has affected our ability to avoid potential neurological injury during spine surgery. We performed a retrospective analysis of cases from 2006 to 2010 to study the frequency and cause of intraoperative events detected via IONM and the clinical outcome of the patient. There were 32 cases (1.5%) with possible intraoperative events. There were 17 (53%) cases where IONM changes affected the course of the surgery and prevented possible postoperative neurological deficits. Seven cases (41%) were due to deformity correction, five (29%) due to hypotension, four (24%) due to patient positioning, and one (6%) due to a screw requiring repositioning. None of the 17 patients had postoperative motor or sensory deficits. There were four cases with false-positive IONM findings due to correctible technical issues. Three cases required surgical revision due to pedicle screw malposition. In each case, s-EMGs failed to exhibit intraoperative changes but the patient presented with postoperative radiculopathy. We believe that the use of t-EMGs may have prevented these complications. This review reinforces the importance of multimodality IONM for spinal surgery. The incidence of possible events in our series was 1.5%, and several likely postoperative neurologic deficits were avoided by intraoperative intervention.
{"title":"Intraoperative Neurophysiological Monitoring (IONM): Lessons Learned from 32 Case Events in 2069 Spine Cases","authors":"Matthew R. Eager, Adam L. Shimer, F. Jahangiri, F. Shen, V. Arlet","doi":"10.1080/1086508X.2011.11079827","DOIUrl":"https://doi.org/10.1080/1086508X.2011.11079827","url":null,"abstract":"ABSTRACT. Intraoperative neurophysiological monitoring (IONM) is becoming the standard of care for many spinal surgeries, especially those with deformity correction and instrumentation. We reviewed 2069 spine cases with multimodality IONM including somatosensory evoked potentials (SSEP), transcranial electrical motor evoked potentials (TCeMEP), and spontaneous and triggered electromyography (s-EMG and t-EMG) in a University setting over a period of four years to examine perioperative clinical findings when an IONM event was noted and to ascertain how IONM has affected our ability to avoid potential neurological injury during spine surgery. We performed a retrospective analysis of cases from 2006 to 2010 to study the frequency and cause of intraoperative events detected via IONM and the clinical outcome of the patient. There were 32 cases (1.5%) with possible intraoperative events. There were 17 (53%) cases where IONM changes affected the course of the surgery and prevented possible postoperative neurological deficits. Seven cases (41%) were due to deformity correction, five (29%) due to hypotension, four (24%) due to patient positioning, and one (6%) due to a screw requiring repositioning. None of the 17 patients had postoperative motor or sensory deficits. There were four cases with false-positive IONM findings due to correctible technical issues. Three cases required surgical revision due to pedicle screw malposition. In each case, s-EMGs failed to exhibit intraoperative changes but the patient presented with postoperative radiculopathy. We believe that the use of t-EMGs may have prevented these complications. This review reinforces the importance of multimodality IONM for spinal surgery. The incidence of possible events in our series was 1.5%, and several likely postoperative neurologic deficits were avoided by intraoperative intervention.","PeriodicalId":7480,"journal":{"name":"American Journal of Electroneurodiagnostic Technology","volume":"274 1","pages":"247 - 263"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81931022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-12-01DOI: 10.1080/1086508X.2011.11079828
Fenghua Li, E. Deshaies, Geoffrey Allott, R. Gorji
ABSTRACT. Cerebral motor evoked potential (MEP) monitoring during arteriovenous malformation (AVM) embolization is not well studied (Söderman et al. 2003). Alterations of cerebral blood flow (CBF) during cerebral embolization could cause ischemia/infarction to the cerebral cortex. Permanent loss of MEPs is correlated with a permanent motor deficit. We report a case of a patient undergoing AVM embolization during which transcranial electrical motor evoked potentials (TCeMEP) reliably predicted changes to CBF induced by selective methohexital testing. Our finding demonstrated that MEPs are a useful means of intraoperative monitoring of motor pathway integrity and predicting changes. The loss of MEP predicted and prevented severe postoperative motor deficits. Intraoperative neuromonitoring with SSEP, TCeMEP, and continuous EEG revealed no changes until the posterior cerebral artery (PCA), but not the anterior cerebral artery (ACA), was injected. TCeMEP may be superior to somatosensory evoked potential (SSEP) and EEG monitoring in predicting motor impairment during AVM surgery.
摘要脑运动诱发电位(MEP)监测在动静脉畸形(AVM)栓塞期间没有得到很好的研究(Söderman et al. 2003)。脑栓塞过程中脑血流量的改变可引起大脑皮层缺血/梗死。永久性mep缺失与永久性运动缺陷相关。我们报告了一例接受AVM栓塞的患者，在此期间，经颅电运动诱发电位(TCeMEP)可靠地预测了选择性甲氧六酮试验引起的CBF变化。我们的研究结果表明，mep是术中监测运动通路完整性和预测变化的有用手段。MEP的丧失预测并预防了严重的术后运动功能障碍。术中神经监测SSEP、TCeMEP和连续脑电图显示，直到注射大脑后动脉(PCA)，而大脑前动脉(ACA)未见变化。TCeMEP在预测AVM手术中运动损伤方面可能优于体感诱发电位(SSEP)和脑电图监测。
{"title":"Transcranial Motor Evoked Potential Changes Induced by Provocative Testing during Embolization of Cerebral Arteriovenous Malformations in Patients under Total Intravenous Anesthesia","authors":"Fenghua Li, E. Deshaies, Geoffrey Allott, R. Gorji","doi":"10.1080/1086508X.2011.11079828","DOIUrl":"https://doi.org/10.1080/1086508X.2011.11079828","url":null,"abstract":"ABSTRACT. Cerebral motor evoked potential (MEP) monitoring during arteriovenous malformation (AVM) embolization is not well studied (Söderman et al. 2003). Alterations of cerebral blood flow (CBF) during cerebral embolization could cause ischemia/infarction to the cerebral cortex. Permanent loss of MEPs is correlated with a permanent motor deficit. We report a case of a patient undergoing AVM embolization during which transcranial electrical motor evoked potentials (TCeMEP) reliably predicted changes to CBF induced by selective methohexital testing. Our finding demonstrated that MEPs are a useful means of intraoperative monitoring of motor pathway integrity and predicting changes. The loss of MEP predicted and prevented severe postoperative motor deficits. Intraoperative neuromonitoring with SSEP, TCeMEP, and continuous EEG revealed no changes until the posterior cerebral artery (PCA), but not the anterior cerebral artery (ACA), was injected. TCeMEP may be superior to somatosensory evoked potential (SSEP) and EEG monitoring in predicting motor impairment during AVM surgery.","PeriodicalId":7480,"journal":{"name":"American Journal of Electroneurodiagnostic Technology","volume":"2 1","pages":"264 - 273"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83245638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-12-01DOI: 10.1080/1086508X.2011.11079830
Lucy R. Sullivan, F. Jahangiri
Lt. Col. William Casebeer directs research conducted by United States Department of Defense, in a special branch known as DARPA, the Defense Advanced Research Projects Agency. The mission of this agency is to imagine futuristic capabilities that would provide an advantage to our military personnel facing combat and to research and produce technologically advanced devices for the military. Lt. Col. Casebeer is working on several projects using advanced EEG applications. Examples of fascinating projects using neural connections include:
{"title":"American Society of Electroneurodiagnostic Technologists 52nd Annual Conference: Co-sponsored by Southern Society of Electroneurodiagnostic Technologists","authors":"Lucy R. Sullivan, F. Jahangiri","doi":"10.1080/1086508X.2011.11079830","DOIUrl":"https://doi.org/10.1080/1086508X.2011.11079830","url":null,"abstract":"Lt. Col. William Casebeer directs research conducted by United States Department of Defense, in a special branch known as DARPA, the Defense Advanced Research Projects Agency. The mission of this agency is to imagine futuristic capabilities that would provide an advantage to our military personnel facing combat and to research and produce technologically advanced devices for the military. Lt. Col. Casebeer is working on several projects using advanced EEG applications. Examples of fascinating projects using neural connections include:","PeriodicalId":7480,"journal":{"name":"American Journal of Electroneurodiagnostic Technology","volume":"165 1","pages":"280 - 295"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76931903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Scott F Davis, Mohamed Abdel Khalek, Jerry Giles, Charles Fox, Lesley Lirette, Emad Kandil
Robotic assisted surgery is becoming widely used for procedures such as radical prostatectomy. The use of robotic assisted surgery to perform partial and complete thyroidectomies using a transaxillary approach is being investigated in patient populations who wish to avoid a conspicuous cervical scar. Patient positioning for this approach as well as retraction during exposure has the potential to result in postoperative brachial plexopathy similar to what is seen in other types of surgery. We report the use of ulnar nerve somatosensory evoked potentials (SSEPs) to detect and prevent positional related neuropathy in the first pediatric patient in the world to undergo this procedure. We conclude that upper extremity SSEPs should be routinely performed during robotic assisted thyroidectomy.
{"title":"Detection and prevention of impending brachial plexus injury secondary to arm positioning using ulnar nerve somatosensory evoked potentials during transaxillary approach for thyroid lobectomy.","authors":"Scott F Davis, Mohamed Abdel Khalek, Jerry Giles, Charles Fox, Lesley Lirette, Emad Kandil","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Robotic assisted surgery is becoming widely used for procedures such as radical prostatectomy. The use of robotic assisted surgery to perform partial and complete thyroidectomies using a transaxillary approach is being investigated in patient populations who wish to avoid a conspicuous cervical scar. Patient positioning for this approach as well as retraction during exposure has the potential to result in postoperative brachial plexopathy similar to what is seen in other types of surgery. We report the use of ulnar nerve somatosensory evoked potentials (SSEPs) to detect and prevent positional related neuropathy in the first pediatric patient in the world to undergo this procedure. We conclude that upper extremity SSEPs should be routinely performed during robotic assisted thyroidectomy.</p>","PeriodicalId":7480,"journal":{"name":"American Journal of Electroneurodiagnostic Technology","volume":"51 4","pages":"274-9"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30434836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-12-01DOI: 10.1080/1086508X.2011.11079826
L. E. Mullikin
ABSTRACT. U.S. Healthcare is not a system but a fragmentation of care delivery mechanisms. Healthcare Reform drives at reducing costs through access, quality, and efficiency. The U.S. economy contracted in 2007 and healthcare spending increased consuming an even greater and potentially unsustainable share of the economic wealth. Affordable care means “shared risk.” The Patient Protection and Accountable Care Act (PPACA) was signed into law on March 23, 2010. The bill outlines the next ten years for new policies and pilot programs. More profound for us are the many provisions that promote fundamental delivery system reform. At this time, the burden of leadership is immense. Our profession needs a large cadre of qualified leaders to shape the future.
{"title":"Kathleen Mears Memorial Lecture: Are We Ready for 2014? An Overview of Healthcare Reform for the Neurodiagnostic Practitioner","authors":"L. E. Mullikin","doi":"10.1080/1086508X.2011.11079826","DOIUrl":"https://doi.org/10.1080/1086508X.2011.11079826","url":null,"abstract":"ABSTRACT. U.S. Healthcare is not a system but a fragmentation of care delivery mechanisms. Healthcare Reform drives at reducing costs through access, quality, and efficiency. The U.S. economy contracted in 2007 and healthcare spending increased consuming an even greater and potentially unsustainable share of the economic wealth. Affordable care means “shared risk.” The Patient Protection and Accountable Care Act (PPACA) was signed into law on March 23, 2010. The bill outlines the next ten years for new policies and pilot programs. More profound for us are the many provisions that promote fundamental delivery system reform. At this time, the burden of leadership is immense. Our profession needs a large cadre of qualified leaders to shape the future.","PeriodicalId":7480,"journal":{"name":"American Journal of Electroneurodiagnostic Technology","volume":"23 1","pages":"229 - 246"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88271689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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