Key Points

• Various techniques for intraoperative neuro-physiological monitoring are available to neurosurgeons for use during procedures that involve both the central and peripheral nervous system.

• Some of these techniques have a proven utility and play an integral role during a number of neurosurgical cases. Other techniques are used as a matter of personal preference or remain in the experimental realm.

• Several of these methods, particularly EEG and SSEP monitoring, are effective at demonstrating neurophysiological changes attributable to ischemia, and therefore are of use in procedures that place the CBF at risk.

• Techniques such as SSEP, MEP, BAEP, EMG and NCV recording allow for monitoring of afferent or efferent activity through regions of the nervous system placed at risk by neuro-surgical manipulation.

• Monitoring/mapping of cortical functions can be performed using techniques such as phase reversal, microelectrode recording or cortical stimulation (either electrical or magnetic).


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