Transcranial electric stimulation motor evoked potentials for cervical spine intraoperative monitoring complications: systematic review and illustrative case of cardiac arrest.

Purpose: We show a systematic review of known complications during intraoperative neuromonitoring (IONM) using transcranial electric stimulation motor evoked potentials (TES-MEP) on cervical spine surgery, which provides a summary of the main findings. A rare complication during this procedure, cardiac arrest by cardioinhibitory reflex, is also described.

Methods: Findings of 523 scientific papers published from 1995 onwards were reviewed in the following databases: CENTRAL, Cochrane Library, Embase, Google Scholar, Ovid, LILACS, PubMed, and Web of Science.

Localization of irritative zones in epilepsy with thermochromic silicone.

Background: During epilepsy surgery, the gold standard to identify irritative zones (IZ) is electrocorticography (ECoG); however, new techniques are being developed to detect IZ in epilepsy surgery and in neurosurgery in general, such as infrared thermography mapping (ITM), and the use of thermosensitive/thermochromic materials.

Methods: In a cohort study of consecutive patients with focal drug-resistant epilepsy of the temporal lobe treated with surgery, we evaluated possible adverse effects to the transient placement of a thermochromic/thermosensitive silicone (TTS) on the cerebral cortex and their postoperative evolution. Furthermore, we compared the precision of TTS for detecting cortical IZ against the gold standard ECoG and with ITM, as proof of concept.

Thermography mapping patterns in temporal lobe epilepsy surgery.

Background: In several epilepsy etiologies, the macroscopic appearance of the epileptogenic tissue is identical to the normal, which makes it hard to balance between how much cytoreduction or disconnection and brain tissue preservation must be done. A strategy to tackle this situation is by evaluating brain metabolism during surgery using infrared thermography mapping (IrTM).

Methods: In 12 epilepsy surgery cases that involved the temporal lobe, we correlated the IrTM, electrocorticography, and neuropathology results.

[Implementation of intraoperative neurophysiologic monitoring in children and adults in secondary and tertiary health care facilities].

Introduction: Intraoperative neurophysiological monitoring (IONM) is a procedure that uses neurophysiological techniques in order to evaluate the motor and sensitive systems during surgeries that endanger the nervous system.

Method: The approach, scope, target population, and clinical questions to be answered were defined. A systematic search of the evidence was conducted step by step; during the first stage, clinical practice guidelines were collected, during the second stage systematic reviews were obtained, and during the third stage, clinical trials and observational studies were procured.

Neurophysiological monitoring in spinal cord surgery.

Background: Intraoperative neurophysiological monitoring (IOM) during spine surgery consists of several functional tests including somatosensory evoked potentials (SSEPs), motor evoked potentials (MEPs), dermatomal potentials (DPs) and EMG (electromyography). Permanent neurological damage after spine surgery performed without intraoperative neurophysiological monitoring is frequent and often very costly. The main goal of IOM is the immediate detection, prevention and correction of neurological damage during surgery, which may go unnoticed without using these tests.

[Type I spinal atrophy (Werdnig-Hoffman disease). Case report].

Background: We report a case of type I spinal muscular atrophy (SMA), also known as Werdnig-Hoffmann disease.

Methods: This was a descriptive case report. The patient was in the pediatric intensive care unit of a medical center.

[Sleep alterations in childhood victims of sexual and physical abuse].

Introduction: The abused child syndrome is related to a variety of emotional disorders, among which are the "post-traumatic stress syndrome" and the phenomena "re-experience," which is related to disturbances of the normal sleep-wake cycle.

Objective: To determine the polysomnographic characteristics of the abused child syndrome and compare them with paired healthy children.

Material And Methods: After two-night habituation, all-night video-digital polygraphic recordings following recommendations of the International Federation of Clinical Neurophysiology were performed in 15 abused child syndrome and 15 healthy controls.

Distortion product otoacoustic emissions test is useful in children undergoing cisplatin treatment.

Background: Cisplatin is a widely used chemotherapy agent that has several adverse effects, such as ototoxicity. Evaluation of hearing loss due to cisplatin therapy in children is difficult. The purpose of this study was to compare the validity of distortion product otoacoustic emissions (DPOAEs) with pure tone audiometry (PTA) in assessing hearing loss in children under cisplatin therapy.

[Perioperative lesions in lower extremity peripheral nerves].

Objective: To review the actual concepts concerning perioperative nerve injuries during surgical or anesthetic procedures.

Material And Methods: A summary of published medical literature from Medline search files and published reviews. CONFLICT IF INTEREST: We have not conflicts of interest.