Effects of intraoperative motor evoked potential amplification following tetanic stimulation of the pudendal nerve in pediatric craniotomy

• Material Type: 博士論文
• Title: Effects of intraoperative motor evoked potential amplification following tetanic stimulation of the pudendal nerve in pediatric craniotomy
• Author/Editor: Sasaki, Ryota; Tamura, Kentaro; Yamazaki, Shintaro; Kim, Tae Kyun; Takatani, Tsunenori; Hayashi, Yoshinobu; Motoyama, Yasushi; Nakagawa, Ichiro; Park, Young-Soo; Kawaguchi, Masahiko; Nakase, Hiroyuki
• Author Heading: Sasaki, Ryota; Tamura, Kentaro; Yamazaki, Shintaro; Kim, Tae Kyun; Takatani, Tsunenori; Hayashi, Yoshinobu; Motoyama, Yasushi; Nakagawa, Ichiro; Park, Young-Soo; Kawaguchi, Masahiko; Nakase, Hiroyuki
• Publication, Distribution, etc.: American Association of Neurological Surgeons
• Publication Date: 2023-02
• Publication Date (W3CDTF): 2023-02
• Alternative Title: 小児開頭手術におけるテタヌス刺激による術中MEP増幅効果の検討
• Periodical title: Journal of Neurosurgery-Pediatrics
• No. or year of volume/issue: 24 31
• Volume: 24
• Issue: 31
• Pages: 488-495
• ISSN (Periodical Title): ISSN : 1933-0707; ISSN : 1933-0715
• Degree grantor/type: 奈良県立医科大学
• Date Granted: 2024-03-14
• Dissertation Number: 甲第896号
• Degree Type: 博士（医学）
• Text Language Code: eng
• Subject Heading: amplification; intraoperative motor evoked potential; pediatric craniotomy; pudendal nerve; surgical technique; tetanic stimulation
• Target Audience: 一般
• Note (General): type:Thesis; Objective: Monitoring the intraoperative motor evoked potentials (MEPs) in pediatric craniotomy is challenging because of its low detection rate, which makes it unreliable. Tetanic stimulation of the peripheral nerves of the extremities and pudendal nerves prior to transcranial electrical stimulation (TES) or direct cortical stimulation (DCS) amplifies the MEPs. The authors investigated the effects of MEP amplification following tetanic stimulation of the median and tibial nerve or the pudendal nerve in pediatric patients undergoing craniotomy. Methods: This prospective observational study included 15 patients ≤ 15 years of age (mean age 8.9 ± 4.9 years) undergoing craniotomy. MEPs were obtained with TES (15 cases) or DCS (8 cases)-conventional MEP without tetanic stimulation (c-MEP) and MEP following tetanic stimulation of the unilateral median and tibial nerves (mt-MEP) or following tetanic stimulation of the pudendal nerve (p-MEP) were used. Compound muscle action potentials were elicited from the abductor pollicis brevis, gastrocnemius, tibialis anterior, and abductor hallucis longus muscles. The authors compared the identification rate and the rate of amplitude increase of each MEP. Results: For both TES and DCS, the identification and amplitude increase rates were significantly higher in cases without preoperative hemiparesis for p-MEPs than in those for c-MEPs and mt-MEPs. In comparison to patients with preoperative hemiparesis, p-MEPs displayed a higher identification rate, with fewer false negatives in DCS cases. Conclusions: In pediatric craniotomy, the authors observed the amplification effect of MEPs with pudendal nerve tetanic stimulation and the amplification effect of DCS on MEPs without increasing false negatives. These findings suggested the likelihood of more reliable intraoperative MEP monitoring in pediatric cases.; 権利情報：© AANS 2023, except where prohibited by US copyright law.; identifier:Journal of Neurosurgery-Pediatrics. 2023 Feb, vol.24, no.31, p.488-495; identifier:1933-0707; identifier:1933-0715; identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/4340; identifier:Journal of Neurosurgery-Pediatrics, 24(31): 488-495
• Access Restrictions: インターネット公開
• Related Material (DOI): 10.3171/2023.1.peds22505
• Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• Original Data Provider (Database): 奈良県立医科大学 : 奈良県立医科大学機関リポジトリ GINMU

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