![]() ![]() Stimulation output was increased from 50 mA in steps of 5 mA until a reproducible MEP was elicited. C3 was the active stimulating electrode position for left cortical stimulation, while C4 was for right cortical stimulation. Stimulating electrodes consisted of 9 mm gold-plated disc electrodes at C3C4 (International 10–20 system) affixed with collodion. In this study, we present our experience on this aspect.į female, R right, L left, I ipsilateral, C contralateral, UL upper limb, LL lower limb, Stim cortical stimulation, TIVA total intravenous anesthesia, NC no change ↓ reduced, N normal, I implant correctionĬortical stimulation alternated with monitoring of somatosensory evoked potentials obtained from posterior tibial nerve stimulation. While the relative contributions of ipsilaterally and transcallosal conducted MEPs remain uncertain, they may together provide additional information regarding the integrity of descending motor tracts. This might also explain the larger amplitudes of ipsilateral MEPs obtained than MEPs derived from contralateral motor cortex stimulation. The lack of significant ipsilateral and contralateral latency differences suggests that bilateral motor cortex stimulation has resulted in ipsilateral MEPs, which may have comprised early ipsilaterally conducted corticoreticulospinal or corticopropriospinal components, and late transcallosally stimulated corticospinal components. In a previous study, we have shown that ipsilateral MEPs of equivalent or larger amplitudes than contralateral MEPs were readily elicited during IOM of scoliosis surgery. Ipsilateral MEP responses have not been adequately studied in this context. In IOM, MEPs are elicited mostly with contralateral cortical electrical stimulation. ![]() In this paper, we would like to further address this novel and important issue. We have previously demonstrated presence of ipsilateral MEPs during IOM for scoliosis surgery, but its significance was uncertain. ![]() In combination with somatosensory evoked potentials, motor evoked potentials (MEPs) monitoring is widely utilized in operations with significant risks of spinal cord damage. Intraoperative monitoring (IOM) of the motor pathways is a routine procedure for ensuring integrity of corticospinal tracts during scoliosis surgery. ![]()
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