American Journal of Electroneurodiagnostic Technology

A 77-year-old male presented with a history of severe lower back pain for 10 years with radiculopathy, positive claudication type symptoms in his calf with walking, and severe "burning" in his legs bilaterally with walking. Magnetic resonance imaging (MRI) revealed lumbar stenosis at the L3-L4 and L4-L5 levels. During the direct or extreme lateral interbody fusion (DLIF/XLIF) procedure, bilateral posterior tibial, femoral, and ulnar nerve somatosensory evoked potentials (SSEPs) were recorded with good morphology of waveforms observed. Spontaneous electromyography (S-EMG) and triggered electromyography (T-EMG) were recorded from cremaster and ipsilateral leg muscles. A left lateral retroperitoneal transpsoas approach was used to access the anterior disc space for complete discectomy, distraction, and interbody fusion. T-EMG ranging from 0.05 to 55.0 mA with duration of 200 microsec was used for identification of the genitofemoral nerve using a monopolar stimulator during the approach. The genitofemoral nerve (L1-L2) was identified, and the guidewire was redirected away from the nerve. Post-operatively, the patient reported complete pain relief and displayed no complications from the procedure. Intraoperative SSEPs, S-EMG, and T-EMG were utilized effectively to guide the surgeon's approach in this DLIF thereby preventing any post-operative neurological deficits such as damage to the genitofemoral nerve that could lead to groin pain.

Faisal R. Jahangiri

Andrea Holmberg

Jonathan H. Sherman

Robert Louis

Jeff Elias

Francisco Vega-Bermudez

Protecting the Genitofemoral Nerve during Direct/Extreme Lateral Interbody Fusion (DLIF/XLIF) Procedures

直接/极外侧椎间融合术（DLIF/XLIF）中保护生殖股神经

Carotid artery stenosis is a major risk factor leading to cerebral infarct, transient ischemic attack (TIA), and ischemic stroke in the United States. While carotid endarterectomy (CEA) surgery has been established as an effective treatment option for severe carotid artery stenosis, many risks remain inherent in performing this procedure. Surgeons will often utilize various intraoperative monitoring techniques in an effort to reduce surgical complications and morbidity. The usefulness of continuous EEG and somatosensory evoked potential (SSEP) monitoring during CEA surgery has been examined by many groups over the last couple decades. The following case review clearly proves that such monitoring is an effective tool in the detection of cerebral ischemic changes and is therefore feasible in CEA surgery.

Brigitte N. Malek

Cindy A. Mohrhaus

Ateer K. Sheth

Use of Multi-Modality Intraoperative Monitoring during Carotid Endarterectomy Surgery: A Case Study

颈动脉内膜切除术中多模态术中监测的应用：一项病例研究

.Triphasic waves (TWs) are a distinctive, although non-specific EEG pattern, which are quite frequently encountered and sometimes difficult to interpret. Although initially considered pathognomonic of hepatic encephalopathy, TWs have been described in association with a large number of conditions. TWs may occur in encephalopathies (metabolic or structural) or as an ictal pattern. Nonepileptic TWs with sharply contoured morphology may resemble epileptic patterns encountered in nonconvulsive status epilepticus (NCSE), thus leading to misinterpretation and overinterpretation of this pattern as ictal, if only the EEG is considered. An electroclinical response to benzodiazepines and the evaluation of consciousness impairment should be considered when interpreting TWs. Evaluating only the EEG without considering also clinical and laboratory findings is not only useless and meaningless, but may even lead to serious consequences.

Francesco Brigo

Monica Storti

Triphasic Waves

三相波

(2011). Waveform Window #19 Seize The Day. American Journal of Electroneurodiagnostic Technology: Vol. 51, No. 1, pp. 54-57.

Andrea Cheng-Hakimian

Cindy Fujimura

Waveform Window #19 Seize The Day

波形窗口 #19 抓住今天

ABSTRACT.ABSTRACT.Tuberous Sclerosis Complex (TSC) is an inherited disorder resulting from mutations in one of two tumor suppressor genes: TSC1 (hamartin) and TSC2 (tuberin). Hamartin and tuberin, the protein products of TSC1 and TSC2, form a functional protein complex in the mTOR pathway that controls cell growth and proliferation. Epilepsy is the most common disorder in TSC, frequently associated with intractable and early onset seizures, and often as infantile spasms. Epilepsy surgery is an option for TSC patients with medically intractable epilepsy. Multimodality neuroimaging has improved the detection of epileptogenic foci, allowing an increased number of TSC patients to be evaluated noninvasively for resective surgery. Advances in understanding of the molecular pathogenesis of the TSC are crucial to establish new therapeutic approaches for individuals with TSC.KEY WORDS.: Epilepsyepilepsy surgeryinfantile spasmsmultimodality neuroimagingTuberous Sclerosis Complex (TSC)

Liliana D. Petrova

Tuberous Sclerosis and Epilepsy

结节性硬化症与癫痫

(1980). The Role of the EEG Technologist in Delineating Pseudoseizures. American Journal of EEG Technology: Vol. 20, No. 2, pp. 89-96.

Terrence L. Riley

Hm Timothy Berndt

The Role of the EEG Technologist in Delineating Pseudoseizures

脑电图技师在区分假性发作中的作用

(1980). Computer Assisted Quantitative Electroretinography I: A Standardized Method. American Journal of EEG Technology: Vol. 20, No. 2, pp. 57-77.

Gian Emilio Chatrian

Ettore Lettich

Paula L. Nelson

R. Colin Miller

Robert J. McKenzie

Richard P. Mills

Computer Assisted Quantitative Electroretinography I: A Standardized Method

计算机辅助定量视网膜电图I：一种标准化方法

Computer Assisted Quantitative Electroretinography II: Separation of Rod and Cone Components of the Electroretinogram in Congenital Achromatopsia and Congenital Nyctalopia

计算机辅助定量视网膜电图II：先天性全色盲和先天性夜盲症中视杆和视锥成分的分离

U.S. Healthcare is not a system but a fragmentation of care delivery mechanisms. Healthcare Reform drives at reducing costs through access, quality, and efficiency. The U.S. economy contracted in 2007 and healthcare spending increased consuming an even greater and potentially unsustainable share of the economic wealth. Affordable care means "shared risk." The Patient Protection and Accountable Care Act (PPACA) was signed into law on March 23, 2010. The bill outlines the next ten years for new policies and pilot programs. More profound for us are the many provisions that promote fundamental delivery system reform. At this time, the burden of leadership is immense. Our profession needs a large cadre of qualified leaders to shape the future.

L. Elizabeth Mullikin

Kathleen Mears Memorial Lecture: Are We Ready for 2014? An Overview of Healthcare Reform for the Neurodiagnostic Practitioner

凯瑟琳·米尔斯纪念讲座：我们准备好迎接2014年了吗？神经诊断从业者的医疗改革概述

Cerebral motor evoked potential (MEP) monitoring during arteriovenous malformation (AVM) embolization is not well studied (Söderman et al. 2003). Alterations of cerebral blood flow (CBF) during cerebral embolization could cause ischemia/infarction to the cerebral cortex. Permanent loss of MEPs is correlated with a permanent motor deficit. We report a case of a patient undergoing AVM embolization during which transcranial electrical motor evoked potentials (TCeMEP) reliably predicted changes to CBF induced by selective methohexital testing. Our finding demonstrated that MEPs are a useful means of intraoperative monitoring of motor pathway integrity and predicting changes. The loss of MEP predicted and prevented severe postoperative motor deficits. Intraoperative neuromonitoring with SSEP, TCeMEP and continuous EEG revealed no changes until the posterior cerebral artery (PCA), but not the anterior cerebral artery (ACA), was injected. TCeMEP may be superior to somatosensory evoked potential (SSEP) and EEG monitoring in predicting motor impairment during AVM surgery.

Fenghua Li

Eric Deshaies

Geoffrey Allott

Reza Gorji

Transcranial Motor Evoked Potential Changes Induced by Provocative Testing during Embolization of Cerebral Arteriovenous Malformations in Patients under Total Intravenous Anesthesia

全凭静脉麻醉下患者脑动静脉畸形栓塞期间诱发试验引起的经颅运动诱发电位变化

出版信息	出版商: American Society of Electroneurodiagnostic Tech. Inc.，出版周期: ，期刊类型: journal，开源期刊: 否
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