Intraoperative Neurophysiological Monitoring For Deep Brain Stimulation

A thorough understanding of electricity, electronics, biophysics, neurophysiology, and neuroanatomy is important to render more tractable, and otherwise complex, electrophysiologically-based targeting in the brain during operative manipulations. Most importantly, electrophysiological monitoring requires controlling the movement of electrons in electronic circuits in order to prevent irreversible damage. This new textbook presents a fundamental discussion of electrons, the forces moving these electrons, and the electrical circuits controlling these forces. The forces that allow recording and analysis also permeate the environment producing interference, such as noise and artifacts. Intraoperative Neurophysiological Monitoring for Deep Brain Stimulation discusses how to avoid or suppress noise and artifacts for the most successful surgical outcome.

This textbook covers virtually every aspect of intraoperative neurophysiological monitoring during Deep Brain Stimulation (DBS) surgery beginning with what is an electron to how to decide whether a given trajectory is optimal for DBS lead placement and if not, where is the optimal trajectory likely to be.

Intraoperative Neurophysiologic Monitoring, Second Edition, contains chapters related to the monitoring of the spinal motor system and deep brain stimulation have been added. The anatomical and physiological basis for these techniques are described in detail as are the practical aspects of such monitoring. Chapters on monitoring of sensory systems and monitoring in skull base surgery have been re-written as has the chapter on monitoring of peripheral nerves.

Completely revised and updated second edition of the leading reference on intraoperative neurophysiology, this book covers IOM from the most basic theoretical and technical concepts to the most sophisticated procedures, placing them within the specific surgical context. Written by a multidisciplinary team of experts from Massachusetts General Hospital/Harvard Medical School, Intraoperative Neurophysiology provides a step-by-step approach to monitoring and mapping for a wide variety of complex surgical procedures by progressively building on prior learned material. Covering everything from set-up to troubleshooting and medical management, this book presents an integrated blueprint for choosing the right tests and customizing IOM procedures to the demands of each surgical challenge. Comprehensive in scope and filled with over 650 helpful illustrations, tables, and neurophysiologic recordings to aid interpretative understanding, this expanded edition includes practical examples of monitoring and mapping and details the importance of an individualized approach to IOM. A highly visual book, it continues to serve as a primary resource for physicians and technologists involved in monitoring to help reduce the operative risk of neurological damage in surgical patients. New to the Second Edition: Extensively broadened coverage of critical topics including mapping procedures brain mapping, and primary neurophysiologic testing in the operating room Six entirely new chapters on pediatric neuromonitoring, cerebral aneurysms, electrocorticography, deep brain stimulation, intradural extramedullary tumors, and cardiac procedures Enhanced decompressive and deformity correction surgery chapters with added description of surgical steps and mechanisms of injury Over 650 high-quality images to enrich and instruct readers Appendix with 100 Q&As with detailed rationales that tie back to the chapters

This widely praised, first-of-its-kind book has been thoroughly updated, expanded, and enriched with extensive new case material, illustrations, and link-outs to multimedia, practice guidelines, and more. Written and edited by outstanding world experts, this was the first and remains the leading single-source volume on intraoperative neurophysiological monitoring (IOM). It is aimed at graduate students and trainees, as well as members of the operative team, including anesthesiologists, technologists, neurophysiologists, surgeons, and nurses. Now commonplace in procedures that place the nervous system at risk, such as orthopedics, neurosurgery, otologic surgery, vascular surgery, and others, effective IOM requires an unusually high degree of coordination among members of the operative team. The purpose of the book is to help students, trainees, and team members acquire a better understanding of one another’s roles and thereby to improve the quality of care and patient safety. From the reviews of the First Edition: “A welcome addition to reference works devoted to the expanding field of nervous system monitoring in the intraoperative period... will serve as a useful guide for many different health care professionals and particularly for anesthesiologists involved with this monitoring modality...An excellent reference...[and] a helpful guide both to the novice and to the developing expert in this field.” ‐‐Canadian Journal of Anesthesia “Impressive... [The book] is well written, indexed, and illustrated...The chapters are all extensively referenced. It is also very good value at the price....I would recommend this book to all residents and especially to all neuroanesthesiologists. It will make a worthwhile addition to their library.” ‐‐Journal of Neurosurgical Anesthesiology

Neurophysiologic intraoperative monitoring (IOM) neurologic monitoring during complex operative procedures is increasingly used to help prevent damage to the nervous system during surgery. Intraoperative Neurophysiology discusses all aspects of IOM with a hands- on approach to this challenging and exciting new frontier. Everything is covered from set-up, monitoring and mapping, troubleshooting, interpretation of results, and medical management. Interweaving contributions from neurologists and surgeons, the book presents a practical integrated blueprint for effective neurophysiological testing in the operating theater. Intraoperative Neurophysiology is visual and comprehensive in scope and coverage. It begins by reviewing basic neurophysiologic and neuroanatomic knowledge and presents detailed technical information on each basic test, providing the foundation necessary for choosing the right test and customizing monitoring and mapping according to the specifics of individual surgical procedures. Intraoperative Neurophysiology utilizes a unique structure to provide insights into successful monitoring practices and techniques. The book uses the steps of each surgical procedure as the skeleton upon which the IOM procedure is built, thereby presenting a developmental step-by-step approach to IOM procedures and the possible complications and pitfalls - that may arise at different moments of the surgery. In addition, it promotes and encourages the use of EEG in the operating room, and offers unprecedented coverage of ECoG, functional mapping, and EEG monitoring. With over 275 illustrations, numerous tables, and the most important clinical points made in writing and exemplified graphically, Intraoperative Neurophysiology: Monitoring and Mapping delivers in words and pictures everything one needs to know to master the art and science of intraoperative neurophysiologic procedure and reduce the operative risk of neurological damage in surgical patients.

In recent decades, the advances in and consolidation of Intraoperative Neurophysiological Monitoring (IOM) in several highly complex surgical areas have been undeniable. Currently all modalities of neurophysiological tests (SSEP, MEP, EMG, PEATC, VEP, BRAIN MAPPING, ETC) are performed in the operating room, where they are used to provide trans operative information on the patient’s neurological status in real time (monitoring), and to identify neural structures which are at immediate risk (mapping). With the inarguably positive impact of IOM on surgical outcomes, there is an increasing interest in reliable, technically focused literature. This volume provides cutting-edge information in the field of IOM, and highlights new neurophysiological tools being used in various surgeries. The book’s initial sections cover a range of topics, including an anatomical overview, electrical safety, and detailed technical descriptions of the neurophysiological tests used in IOM. The subsequent sections address e.g. the brain, brainstem, spinal cord, vascular and peripheral nerves, epilepsy, head and neck, movement disorders and special topics. Some chapters are accompanied by videos of surgeries and IOM so that the reader will have the real sensation of having been in the operating room and will gain an overview of the key steps. Written by experts in the field of IOM, the book offers a valuable resource for both experienced and early-career neurophysiologists, neurosurgeons, vascular and orthopedic surgeons, and surgeons involved with pelvic procedures. Further, its goal is to provide a real rapport, never before attained, between neurophysiologists and surgeons with a sole focus: excellence in terms of the final outcome.

Intraoperative Neurophysiological Mapping of the Brain. This book is a quick reference guide to anyone who is interested in the intraoperative neurophysiological concepts and technical details of sensory, motor, and language mapping during brain surgeries. These chapters are separated for sensory mapping, cortical and subcortical mapping, and language mapping techniques. You will find the stimulation and recording parameters as well.