Predictive value of neurophysiologic monitoring during neurovascular intervention for postoperative new neurologic deficits

Purpose Forms of intraoperative neurophysiologic monitoring (IONM), including somatosensory evoked potentials (SSEPs) and motor evoked potentials (MEPs), have been widely used in the field of neurosurgery. This study aimed to evaluate the diagnostic efficacy of IONM in identifying intraoperative eve...

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Bibliographic Details
Published in:Neuroradiology 2019-02, Vol.61 (2), p.207-215
Main Authors: Lee, Sungjoon, Kim, Doo Young, Kim, Su Bin, Kim, Woojin, Kang, Mi-Ri, Kim, Hye-Jin, Lee, Ki Hwa, Yoo, Minwook, Choi, Byung-Sam, Kim, Jung Soo, Lee, Sun-Il, Kim, Hae Yu, Jin, Sung-Chul
Format: Article
Language:English
Subjects:
Anesthesia
Complications
Diagnostic systems
Evoked potentials
Imaging
Intervention
Interventional Neuroradiology
Latency
Mathematical analysis
Medicine
Medicine & Public Health
Monitoring
Motor evoked potentials
Neurological complications
Neurology
Neuroradiology
Neurosciences
Neurosurgery
Patients
Radiology
Sensitivity
Somatosensory evoked potentials
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Summary:Purpose Forms of intraoperative neurophysiologic monitoring (IONM), including somatosensory evoked potentials (SSEPs) and motor evoked potentials (MEPs), have been widely used in the field of neurosurgery. This study aimed to evaluate the diagnostic efficacy of IONM in identifying intraoperative events and predicting postoperative neurologic deficits in neurovascular intervention. Methods From January 2013 to December 2016, we retrospectively reviewed patients who underwent neurovascular intervention under general anesthesia with the use of IONM. Associations between significant changes in MEPs or SSEPs which were defined as a decrease more than 50% in amplitude and/or an increase more than 10% in latency and any identifiable intraoperative events and/or postoperative neurologic deficits were determined. The sensitivity and specificity values for both MEPs and SSEPs were calculated. Results In total, 578 patients (175 men and 403 women) were included. Their mean age was 59.5 years. SSEP changes occurred in 1% ( n  = 6), and MEP changes occurred in 1.2% ( n  = 7). Four patients suffered postoperative neurologic deficits, and identifiable intraoperative events were observed in seven patients. Both SSEP and MEP changes were significantly associated with identifiable intraoperative events and/or postoperative neurologic deficits ( p  
ISSN:0028-3940
1432-1920
DOI:10.1007/s00234-018-2115-0