Browse > Article
http://dx.doi.org/10.15324/kjcls.2018.50.2.211

Usefulness of Direct Cortical Stimulation During Intraoperative Monitoring in Patients with Brain Tumor Near Motor Cortex: Case Report  

Lim, Sung-Hyuk (Department of Neurology, Samsung Medical Center)
Park, Sang-Ku (Department of Neurology, Samsung Medical Center)
Kim, Dong-Jun (Department of Neurology, Samsung Medical Center)
Baek, Jae-Seung (Department of Neurology, Samsung Medical Center)
Park, Chan-Woo (Department of Neurology, Samsung Medical Center)
Publication Information
Korean Journal of Clinical Laboratory Science / v.50, no.2, 2018 , pp. 211-215 More about this Journal
Abstract
The aim of this study was to preserve the corticospinal tract during surgery and assess more accurately the motor performance in brain tumor patients around the motor cortex. TceMEP is not entirely reliable, even though there has been no change in waveforms due to a mixture of false positive and false negative signals. For a more detailed examination, DCS was employed to selectively stimulate the motor cortex. In both cases, the indications could find the region to which the cortex was responsible, and constantly check and examine the changes in amplitude, thereby preserving the motor pathway and performing surgery. On the other hand, patients who did not implement the DCS but did implement the TceMEP experienced a decrease in their postoperative motor performance. DCS is a very useful examination and it is a method that can reduce the post-surgery disorder that may occur in patients with the TceMEP in brain tumor surgery.
Keywords
Direct cortical stimulation; Motor evoked potentials; Corticospinal tract;
Citations & Related Records
Times Cited By KSCI : 2  (Citation Analysis)
연도 인용수 순위
1 Hong JY, Suh SW, Modi HN, Hur CY, Song HR, Park JH. 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. 2010;35:E912-E916.   DOI
2 Szelenyi A, Kothbauer KF, Deletis V. Transcranial electric stimulation for intraoperative motor evoked potential monitoring: stimulation parameters and electrode montages. Clin Neurophysiol. 2007;118:1586-1595.   DOI
3 Kaye AD, Davis SF. Principle of neurophysiological assessment, mapping, and monitoring. 1ed. New York: Springer-Verlag; 2014. p107-127.
4 Allison T, McCarthy G, Wood CC, Darcey TM, Spencer DD, Williamson PD. Human cortical potentials evoked by stimulation of the median nerve. I. Cytoarchitectonic areas generating short-latency activity. J Neurophysiol. 1989;62:694-710.   DOI
5 Seo DW, Hong SB. Comparison of perirolandic sensorimotor function using somatosensory evoked potentials and brain stimulation in patients with epilepsy. J Kor Neurol Ass. 1999;17:498-504.
6 Kombos T, Suss O. Neurophysiological basis of direct cortical stimulation and applied neuroanatomy of the motor cortex: a review. Neurosurg Focus. 2009;27:1-7.
7 Park SK, Hyun SC, Lim SH, Park CW, Park JW, Kim DJ, et al. Basic techniques of intraoperative neurophysiological monitoring. Korean J Clin Lab Sci. 2013;45:77-85.
8 Lim SH, Park SK, Han HT. Effective motor evoked potential waveforms in patients with lower extremity weakness. Korean J Clin Lab Sci. 2016;48:41-48.   DOI
9 Park SK, Park SN. Intraoperative neurophysiological monitoring for optimal brain mapping. Korean J Clin Lab Sci. 2013;45:170-179.
10 Lee JJ, Kim YL, Hong JT, Sung JH, Lee SW, Yang SH. Intraoperative monitoring of motor-evoked potentials for supratentorial tumor surgery. J Korean Neurosurg Soc. 2014;56:98-102.   DOI