title: Assessment: intraoperative neurophysiology. Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology.
abstract: Experience to date in both humans and controlled animal research studies substantiates that several electrophysiology tests and monitoring techniques are safe and efficacious, to a variable degree, as commonly applied in the operating room for the following procedures: EEG or SEP to monitor for cerebral ischemia; ECoG and SEP sensory cortex identification to define the limits of cortical resection; SEP spinal cord monitoring; BAEP and cranial nerve EMG monitoring during posterior fossa procedures; functional localization of cortex with direct cortical stimulation in expert hands; and EMG and compound muscle and nerve action potential measurements of various peripheral nervous system structures. All these techniques need to be applied by a well-trained, knowledgeable physician-neurophysiologist or personnel directly under his or her supervision. Clinical situations need to be chosen carefully, avoiding those in which the nervous system is only at low risk.
mesh_terms: D000047:Academies and Institutes; D004594:Electrophysiology; D005073:Evoked Potentials, Somatosensory / Q000502:physiology; D006801:Humans; D016343:Monitoring, Intraoperative / Q000379:methods / Q000592:standards*; D009420:Nervous System / Q000503:physiopathology*; D009462:Neurology; D019635:Neurosurgical Procedures; D013673:Technology Assessment, Biomedical; D014481:United States