Summary
Following transcranial electrical cortex stimulation motor evoked potentials (MEP) were monitored in 4 patients during 2 angiographic examinations and 4 therapeutic embolization procedures. Changes of MEP were observed in all 4 patients. Temporary decrease of MEP amplitudes as found in two patients was not followed by any additional postoperative neurological deficits. Incomplete recovery of amplitudes in one case associated with a corresponding hemiparesis post-angiographically. In the last patient amplitude reduction was found one week after the second embolization of an av-angioma. Consequently, an angiographic control was performed early, showing a partial revascularisation by newly opened fistulae which needed to be embolized again. In our opinion, monitoring of MEP during interventional neuroradiology is a sensitive method for early detection of impending neurological deficits. The use of MEP monitoring is discussed with respect to the advantages and limitations of conventional SEP monitoring. Because of the discomfort associated with electrical stimulation a magnetic stimulator may be used.
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References
Barker AT, Jalinous R, Freestone IL (1985) Non-invasive magnetic stimulation of the human cortex. Lancet II: 1106–1107
Berenstein A, Young W, Ransohoff J, Benjamin V, Merkin H (1984) Somatosensory evoked potentials during spinal angiography and therapeutic transvascular embolization. J Neurosurg 60:777–785
Djindjan R, Murth M, Mamo H, Houdart R (1973) L'embolisation de la voie artérielle spinale antérieure. Indications thérapeutiques. Rev Neurol 128: 385–400
Hacke W (1985) Neuromonitoring during interventional neuroradiology. CNS Trauma 2: 123–136
Hacke W, Berg-Damer E, Zeumer H (1982) Evoked potential monitoring during acute occlusion of the basilar artery and selective local thrombolytic therapy. Arch Psychiatr Nervenkr 232: 541–548
Hacke W, Buchner H, Ferbert A, Zeumer H, Böcker G (1985) Evoked potential monitoring during interventional neuroradiology. Experimental aspects of special catheter techniques. In: Schramm J, Jones SJ (eds) Spinal cord monitoring. Springer, Berlin Heidelberg New York
Hacke W, Hundgen R, Zeumer H, Ferbert A, Buchner H: (1985) Überwachung der therapeutischen neuroradiologischen Untersuchungs- und Therapieverfahren mittels evozierten Potentialen. Z EEG-EMG 16: 93–100
Hess CW, Mills KR, Murray NMF (1980) Magnetic stimulation of the human brain: facilitation of motor responses by voluntary contraction of ipsilateral and contralateral muscles with additional observations on an amputee. Neurosci Lett 71: 235–240
Merland JJ, Riché MC, Chiras J (1980) Les fistules artérioveneuses intra-canulaires, extra-médullaires à drainage veneux médullaire. J Neuroradiol 7: 271–280
Merton PA, Morton HB (1980) Stimulation of the cerebral cortex in the intact human subject. Nature 225: 227
Reizine D, Laouiti M, Guimaraens L, Riche MC, Merland JI (1985) Les fistules artério-veneuses vertébrales. Ann Radiol 28: 425–438
Riché MC, Modenesi-Freitas J, Djindjan R, Merland JI (1982) Arteriovenous malformations (AVM) of the spinal cord in children. Neuroradiology 22: 171–180
Young W, Berenstein A (1985) Somatosensory evoked potential monitoring of intraoperative procedures. In: Schramm J, Jones SJ (eds) Spinal cord monitoring. Springer, Berlin Heidelberg New York
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Zentner, J., Schumacher, M. & Bien, S. Motor evoked potentials during interventional neuroradiology. Neuroradiology 30, 252–255 (1988). https://doi.org/10.1007/BF00341837
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DOI: https://doi.org/10.1007/BF00341837