Intraoperative electrical stimulation mapping as an aid for surgery of intracranial lesions involving motor areas in children.
OBJECTIVE
We analysed the usefulness of intraoperative electrical stimulation mapping (ESM) for locating motor pathways in pediatric patients harboring cerebral lesions closely related to motor areas.


METHODS
We applied ESM in 17 consecutive pediatric patients operated on under general anesthesia. It was possible to locate motor function in 15 patients and in all children 5 years old and younger, as well as in all patients presenting with severe motor deficits, using relatively high current intensities. Intraoperative seizures occurred in 20% of our patients. A macroscopically complete removal of the lesion was carried out in 12 cases out of 17 with no definitive postoperative aggravation. Motor function improved for all patients presenting preoperatively with a severe paresis.


CONCLUSIONS
In our experience ESM revealed to be an useful tool for allowing us to push the resection of any lesion infringing on eloquent cortex up to the limit of functional areas, even in cases in very young and severely paretic children.
Signorelli
Francesco
F
Service de Neurochirurgie D, Hôpital Neurologique, 59 Boulevard Pinel, BP Lyon-Monchat, 69394, Lyon 03, France. f.signorelli@medscape.com
Guyotat
J
J
Mottolese
C
C
Schneider
F
F
D'Acunzi
G
G
Isnard
J
J
D000293:Adolescent; D001927:Brain Diseases / Q000601:surgery*; D001931:Brain Mapping; D002648:Child; D002675:Child, Preschool; D004558:Electric Stimulation / Q000379:methods*; D005260:Female; D006801:Humans; D007432:Intraoperative Period / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009044:Motor Cortex / Q000473:pathology / Q000503:physiopathology / Q000528:radiation effects / Q000601:surgery*; D019635:Neurosurgical Procedures; D014055:Tomography, Emission-Computed / Q000379:methods