Identification of motor pathways during tumor surgery facilitated by multichannel electromyographic recording
Identification of motor pathways during tumor surgery facilitated by multichannel electromyographic recording
复制标题
DOI：
10.3171/jns.1999.91.6.0922
复制
发表时间：
1999-12-01
影响因子：
4.1
通讯作者：
Berger, MS
中科院分区：
文献类型：
--
作者：
Yingling, CD;Ojemann, S;Berger, MS
物体。本研究的目的是确定肌电(EMG)记录在手术中定位中央沟或内囊附近运动通路的有效性。将多通道肌电记录与直接皮质或皮质下刺激引起的对侧身体运动的视觉观察进行比较，以确定肿瘤切除前和肿瘤切除期间的运动路径。在识别运动反应方面，肌电记录比单独视觉观察更敏感。在30%的病例中，仅通过术中某个时间点的肌电记录就能识别出反应，在9%的病例中，肌电反应是唯一观察到的反应。此外，肌电记录经常检测到由电刺激大脑皮层引起的癫痫活动，这在肉眼检查中是无法识别的。本组88%的患者术后无新的运动功能障碍。在运动路径映射的同时使用肌电记录可以提高敏感性，允许使用较低的刺激水平，并有助于检测刺激诱导的癫痫活动。
Object. The goal of this study was to determine the usefulness of electromyographic (EMG) recording in locating motor pathways near the central sulcus or internal capsule during surgery.Methods. Multichannel EMG recordings were compared with visual observation of contralateral body movement that was elicited by direct cortical or subcortical stimulation used to identify motor pathways before and during tumor resection.The EMG recordings were more sensitive than visual observation alone in identifying motor responses. in 30% of cases, responses were identified by EMG recording alone at some point during the operation and, in 9% of cases, EMG responses were the only responses observed. Additionally, EMG recordings often detected seizure activity resulting from electrical stimulation of the cortex that could not be appreciated on visual inspection. No new motor deficits were seen postoperatively in 88% of the patients in this series.Conclusions. Using EMG recording in addition to motor pathway mapping results in greater sensitivity, allowing the use of lower stimulation levels and facilitating detection of stimulation-induced seizure activity.