These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: Stimulation threshold potentials of intraoperative cortical motor mapping using monopolar trains of five in pediatric epilepsy surgery.
    Author: Ng WH, Ochi A, Rutka JT, Strantzas S, Holmes L, Otsubo H.
    Journal: Childs Nerv Syst; 2010 May; 26(5):675-9. PubMed ID: 19949801.
    Abstract:
    OBJECTIVE: Direct cortical stimulation in commonly used for the accurate localization of the motor cortex but the electrical threshold stimulation parameters with this technique had not been fully established. PATIENTS AND METHODS: A retrospective review of 15 cases of pediatric surgical cases were performed. The patients consisted of nine male patients and six female patients with age range from 2 to 18 years (mean: 10.8 years; median: 14 years). The most common pathology was cortical dysplasia (nine cases). Stimulation was performed with a train of five stimulations (range five-seven stimulations; <5% of stimulations required more than five stimulations) applied, each train of 50 micros pulse duration, with an interstimulus interval of 1.1 msec. Stimulation intensity commenced at 25 V and this was increased at 5-10 V increments until motor evoked potentials waveforms of sufficient duration and morphology were consistently generated. RESULTS: Monopolar electrical stimulation threshold for intraoperative motor cortical mapping were found to be more consistent in the upper limb compared to lower limb and facial muscles. Evoked responses from the extensor digitorium communis had the highest recorded rate (83.7%) and required the lowest stimulation voltage (36.0 V). The stimulation voltage was found to be statistically significant compared to threshold values for abductor hallucis, tibialis anterior, deltoid, and orbicularis oris with respective p values of 0.006, 0.021, 0,027, and 0.015. There was also a distinct trend that patients with cortical dysplasia/tuberous sclerosis have higher stimulation thresholds when compared to other pathology (p = 0.067). CONCLUSION: Monopolar electrical stimulation threshold for intraoperative motor cortical mapping were more consistent in the upper limb compared to lower limb and facial muscles. Evoked responses from the extensor digitorium communis had the highest recorded rate and required the lowest stimulation voltage. There was also a distinct trend that patients with cortical dysplasia/tuberous sclerosis have higher stimulation thresholds.
    [Abstract] [Full Text] [Related] [New Search]