Skip to main content
Journal cover image

The incidence of unacceptable movement with motor evoked potentials during craniotomy for aneurysm clipping.

Publication ,  Journal Article
Hemmer, LB; Zeeni, C; Bebawy, JF; Bendok, BR; Cotton, MA; Shah, NB; Gupta, DK; Koht, A
Published in: World Neurosurg
January 2014

OBJECTIVE: To review the experience at a single institution with motor evoked potential (MEP) monitoring during intracranial aneurysm surgery to determine the incidence of unacceptable movement. METHODS: Neurophysiology event logs and anesthetic records from 220 craniotomies for aneurysm clipping were reviewed for unacceptable patient movement or reason for cessation of MEPs. Muscle relaxants were not given after intubation. Transcranial MEPs were recorded from bilateral abductor hallucis and abductor pollicis muscles. MEP stimulus intensity was increased up to 500 V until evoked potential responses were detectable. RESULTS: Out of 220 patients, 7 (3.2%) exhibited unacceptable movement with MEP stimulation-2 had nociception-induced movement and 5 had excessive field movement. In all but one case, MEP monitoring could be resumed, yielding a 99.5% monitoring rate. CONCLUSIONS: With the anesthetic and monitoring regimen, the authors were able to record MEPs of the upper and lower extremities in all patients and found only 3.2% demonstrated unacceptable movement. With a suitable anesthetic technique, MEP monitoring in the upper and lower extremities appears to be feasible in most patients and should not be withheld because of concern for movement during neurovascular surgery.

Duke Scholars

Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

January 2014

Volume

81

Issue

1

Start / End Page

99 / 104

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Neurosurgical Procedures
  • Muscle, Skeletal
  • Muscle Relaxants, Central
  • Movement
  • Monitoring, Intraoperative
  • Intraoperative Period
  • Intracranial Aneurysm
  • Hypothermia, Induced
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Hemmer, L. B., Zeeni, C., Bebawy, J. F., Bendok, B. R., Cotton, M. A., Shah, N. B., … Koht, A. (2014). The incidence of unacceptable movement with motor evoked potentials during craniotomy for aneurysm clipping. World Neurosurg, 81(1), 99–104. https://doi.org/10.1016/j.wneu.2012.05.034
Hemmer, Laura B., Carine Zeeni, John F. Bebawy, Bernard R. Bendok, Mathew A. Cotton, Neil B. Shah, Dhanesh K. Gupta, and Antoun Koht. “The incidence of unacceptable movement with motor evoked potentials during craniotomy for aneurysm clipping.World Neurosurg 81, no. 1 (January 2014): 99–104. https://doi.org/10.1016/j.wneu.2012.05.034.
Hemmer LB, Zeeni C, Bebawy JF, Bendok BR, Cotton MA, Shah NB, et al. The incidence of unacceptable movement with motor evoked potentials during craniotomy for aneurysm clipping. World Neurosurg. 2014 Jan;81(1):99–104.
Hemmer, Laura B., et al. “The incidence of unacceptable movement with motor evoked potentials during craniotomy for aneurysm clipping.World Neurosurg, vol. 81, no. 1, Jan. 2014, pp. 99–104. Pubmed, doi:10.1016/j.wneu.2012.05.034.
Hemmer LB, Zeeni C, Bebawy JF, Bendok BR, Cotton MA, Shah NB, Gupta DK, Koht A. The incidence of unacceptable movement with motor evoked potentials during craniotomy for aneurysm clipping. World Neurosurg. 2014 Jan;81(1):99–104.
Journal cover image

Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

January 2014

Volume

81

Issue

1

Start / End Page

99 / 104

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Neurosurgical Procedures
  • Muscle, Skeletal
  • Muscle Relaxants, Central
  • Movement
  • Monitoring, Intraoperative
  • Intraoperative Period
  • Intracranial Aneurysm
  • Hypothermia, Induced
  • Humans