BACKGROUND: The aims of this study were to reveal the strategies and pitfalls of motor-evoked potential ( @entity27026 ) monitoring methods during supratentorial @entity439 surgery, and to discuss the drawbacks and advantages of each method by reviewing our experiences. METHODS: Intraoperative @entity27026 monitoring was performed in 250 @entity1 . Results from 4 monitoring techniques using combinations of 2 stimulation sites and 2 recording sites were analyzed retrospectively. RESULTS: @entity27026 was recorded successfully in 243 @entity1 (97.2%). Direct cortical stimulation (DCS)-spinal recorded @entity27026 (sMEP) was used in 134 @entity1 , DCS-muscle recorded @entity27026 ( @entity69603 ) in 97, transcranial electrical stimulation (TES)-mMEP in 11 and TES-sMEP in 1. TES-mMEP during closure of the skull was used in 21 @entity1 . DCS-mMEP was able to detect waveforms from upper and/or lower limb muscles. Alternatively, DCS-sMEP (direct [D]-wave) could accurately estimate amplitude changes. A novel "early warning sign" indicating @entity63 was found in 21 @entity1 , which started with a transiently increased amplitude of D-wave and then decreased after proximal interruption of major arteries. False-negative findings in @entity27026 monitoring in 2 @entity1 were caused by a @entity551 and by a TES-sMEP recording, respectively. CONCLUSIONS: The results of this study suggest that to perform accurate @entity27026 monitoring, DCS-mMEP or DCS-sMEP recording should be used as the situation demands, with combined use of TES-mMEP recording during closure of the skull. DCS-sMEP is recommended for accurate analysis of waveforms. We also propose a novel "early warning sign" of @entity1887 in the D-wave.

Strategies and Pitfalls of Motor-Evoked Potential Monitoring during Supratentorial XXXX Surgery.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity63 :: ('MESH:D007511', 'Disease') :: ['ischemia'] @entity69603 :: ('MESH:C079977', 'Chemical') :: ['mMEP'] @entity27026 :: ('CHEBI:34757', 'Chemical') :: ['MEP'] @entity1887 :: ('MESH:D000309', 'Disease') :: ['blood insufficiency'] @entity439 :: ('MESH:D000783', 'Disease') :: ['aneurysm'] @entity551 :: ('MESH:D007022', 'Disease') :: ['blood insufficiency in the lenticulostriate artery']
@entity439 :: (MESH:D000783,Disease) :: ['Aneurysm']
