Transcranial electrical stimulation through screw electrodes for intraoperative monitoring of motor evoked potentials. Technical note.

Abstract:

:The feasibility of high-frequency transcranial electrical stimulation (TES) through screw electrodes placed in the skull was investigated for use in intraoperative monitoring of the motor pathways in patients who are in a state of general anesthesia during cerebral and spinal operations. Motor evoked potentials (MEPs) were elicited by TES with a train of five square-wave pulses (duration 400 microsec, intensity < or = 200 mA, frequency 500 Hz) delivered through metal screw electrodes placed in the outer table of the skull over the primary motor cortex in 42 patients. Myogenic MEPs to anodal stimulation were recorded from the abductor pollicis brevis (APB) and tibialis anterior (TA) muscles. The mean threshold stimulation intensity was 48 +/- 17 mA for the APB muscles, and 112 +/- 35 mA for the TA muscles. The electrodes were firmly fixed at the site and were not dislodged by surgical manipulation throughout the operation. No adverse reactions attributable to the TES were observed. Passing current through the screw electrodes stimulates the motor cortex more effectively than conventional methods of TES. The method is safe and inexpensive, and it is convenient for intraoperative monitoring of motor pathways.

journal_name

J Neurosurg

journal_title

Journal of neurosurgery

authors

Watanabe K,Watanabe T,Takahashi A,Saito N,Hirato M,Sasaki T

doi

10.3171/jns.2004.100.1.0155

subject

Has Abstract

pub_date

2004-01-01 00:00:00

pages

155-60

issue

1

eissn

0022-3085

issn

1933-0693

journal_volume

100

pub_type

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