title: Motor evoked potentials enable differentiation between motor and sensory branches of peripheral nerves in animal experiments.
abstract: Differentiation between motor and sensory fascicles is frequently necessary in reconstructive peripheral nerve surgery. The goal of this experimental study was to verify if centrally motor evoked potentials (MEP) could be implemented to differentiate sensory from motor fascicles, despite the well-known intermingling between nerve fascicles along their course to their distant periphery. This new procedure would enable surgeons to use MEP for placing nerve grafts at corresponding fascicles in the proximal and distal stumps without the need to use time-consuming staining. In ten sheep, both ulnar nerves were exposed at the terminal bifurcation between the last sensory and motor branch. Animals were then relaxed to avoid volume conduction. On central stimulation, the evoked nerve compound action potentials were simultaneously recorded from both terminal branches. In all cases, neurogenic motor nerve action potentials were recorded only from the terminal motor branch. The conclusion was that MEPs can be used for intraoperative differentiation between sensory and motor nerves. Further studies are necessary to develop this method for in situ measurements on intact nerve trunks.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Surgical University Clinic of Vienna, Austria.
authors.forename: Edvin
authors.initials: E
authors.lastname: Turkof
authors.forename: Nikita
authors.initials: N
authors.lastname: Jurasch
authors.forename: Erik
authors.initials: E
authors.lastname: Knolle
authors.forename: Ilse
authors.initials: I
authors.lastname: Schwendenwein
authors.forename: Danja
authors.initials: D
authors.lastname: Habib
authors.forename: Ewald
authors.initials: E
authors.lastname: Unger
authors.forename: Martin
authors.initials: M
authors.lastname: Reichel
authors.forename: Udo
authors.initials: U
authors.lastname: Losert
mesh_terms: D000818:Animals; D019054:Evoked Potentials, Motor / Q000502:physiology*; D005260:Female; D007432:Intraoperative Period; D008297:Male; D010525:Peripheral Nerves / Q000033:anatomy & histology / Q000502:physiology*; D012756:Sheep; D014459:Ulnar Nerve / Q000033:anatomy & histology / Q000502:physiology