Intra-operative monitoring as an adjuvant to standard vagus nerve stimulation implantation.

Purpose: The treatment of refractory epilepsy by vagus nerve stimulation (VNS) is a well-established therapy. Complications following VNS insertion may be procedure-related or stimulation-related. Herein, we describe our technique of intra-operative neuro-monitoring (IONM) in an attempt to diminish these adverse events.

Use of intra-operative stimulation of brainstem lesion target sites for frameless stereotactic biopsies.

Introduction: Frameless stereotactic navigation is used to direct the trajectory and biopsy site of target lesions. We report on a novel intra-operative stimulating (IOS) probe that is integrated into a commercially available stereotactic biopsy needle with the rationale that stimulation of the intended biopsy site should predict functional tissue thus preventing inadvertent biopsy of eloquent tissue.

Methods: Patients undergoing brainstem biopsies for atypical lesions were offered the additional stimulation procedure.