Intraoperative Neurophysiological Monitoring

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.

The third edition of this classic text again provides practical, comprehensive coverage of the anatomical and physiological basis for intraoperative neurophysiological monitoring. Written by a leading authority in the field, Dr. Aage Moller has updated this important title to again offer all the leading-edge knowledge needed to perform electrophysiological recordings in the operating room, to interpret the results, and to present the results to the surgeon. The field known as "intraoperative monitoring" has expanded rapidly to cover other uses of neurophysiology and electrophysiologic recordings during surgical operations that affect the brain, spinal cord, and other parts of the nervous system. These new areas are covered in this new edition. To better represent the content of the book and the field as it now stands, many of the chapters have been revised and new material has been added. While the general organization of the book is maintained, chapters such as monitoring of motor systems have been revised and extended with new material, including more detailed description of the anatomy and physiology of motor systems and new information about intraoperative monitoring.

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.

Thorough understanding of electricity, electronics, biophysics, neurophysiology, and neuroanatomy renders more tractable otherwise complex electrophysiologically-based targeting. The textbook integrates these subjects in a single resource. Ultimately, electrophysiological monitoring required controlling the movement of electrons in electronic circuits. Thus, the textbook begins with fundamental discussions of electrons, the forces moving 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 artifact. The textbook discusses noise and artifact and the measures to avoid or suppress them. The textbook discusses interpretive principles and methods for translating electrophysiological information collected along a trajectory into an understanding of the trajectory's functional-anatomical location, as well as its optimal location and direction. Forms included allow one to document observations, consult algorithms, and interpret data. Other discussions cover safe brain stimulation, correct interpretation of patient responses, procedures of targeted neurological examinations to assess patients' condition in response to stimulation and any surgical consequences, various aspects and limitations of image-based surgical planning, and principles governing use of electrode-guiding mechanical devices.

Intraoperative neurophysiologic monitoring has shown a steady increase in use for surgeries in which neural structures may be at risk of injury. Some of the surgical techniques used carry inherent risks, and these risks have changed the way in which neurophysiologic monitoring has impacted patient safety and quality of care during surgical procedures. It is therefore crucial that those performing and interpreting intraoperative neurophysiologic monitoring are adequately trained. This book is a comprehensive guide to the current practice of intraoperative neurophysiology with chapters on various modalities and clinical uses. Separate chapters devoted to anesthesia, operating room environment, special considerations in pediatrics and the interpretation and reporting of neurophysiologic data are useful and complementary. Questions and detailed answers on the topics covered can be found on the accompanying website for study review. This book will be useful to the trainee as well as the neurophysiologist already in practice.

Over the last 18 years, there have been many advances in the field of intraoperative monitoring. This new edition of Neurophysiology in Neurosurgery: A Modern Approach provides updates on the original techniques, as well as other more recent methodologies that may either prove beneficial or are commonly used in neuromonitoring. The purpose of this book is to describe the integration of neuromonitoring with surgical procedures. Each methodology is discussed in detail as well as chapters describing how those methodologies are applied to multiple surgical procedures and the evidence used to support those uses. The second edition features a surgical procedure section, which focuses on specific surgical procedures and the type of monitoring used during these procedures. The original chapters have been updated, expanded, and the structure modified to ensure the book is beneficial to both physiologists and surgeons. This book is written for neurosurgeons, neurophysiologists, neurologists, anesthesiologists, interventional neuroradiologists, orthopedic surgeons, and plastic surgeons. Provides a valuable educational tool that describes the theoretical and practical aspects of intraoperative monitoring through example Presents in-depth descriptions of the most advanced techniques in intraoperative neurophysiological monitoring and mapping Features a surgical procedures section that focuses on specific surgical procedures and the type of monitoring used during these procedures

Intraoperative Neuromonitoring takes you step by step through the proper protocols for measuring and mapping neural function, emphasizing the correct application of intraoperative recordings for improved surgical outcomes. You will learn how to utilize the very latest neuromonitoring tools, and familiarize yourself with the full range of topics pertaining to intraoperative monitoring in neurosurgery. The authors also present both common and lesser-known techniques for neural assessment, resulting in a stand-alone reference that helps you master any type of neuromonitoring for virtually every kind of procedure. The most complete, expert-authored intraoperative neuromonitoring resource, addressing the most current topics, tools, and techniques to enhance your skills. Logical five-part organization clearly explains must-know topics such as neuromonitoring during cerebrovascular surgery, mapping cerebral and brainstem function, neuromonitoring in spinal surgery peripheral nerve procedures, and more.

Intra-operative neuromonitoring (IONM) refers to a diverse and evolving collection of techniques used to provide real-time assurance of neurological integrity during surgery. Most frequently utilised during neurosurgical procedures, the use of IONM has increased dramatically over recent years, and there is an ongoing need for structured and accessible information in its principles, implementation and interpretation. This dynamic book provides a practical overview of IONM, in simple language and clearly illustrated. Uniquely, it is authored by experienced multidisciplinary clinicians affiliated to Kingâ (TM)s College Hospital NHS Foundation Trust, a regional neurosciences centre in London, UK. Combining the expertise of anaesthetists, physiologists, surgeons and patients themselves, this guide represents an invaluable source of information for all staff and trainees involved in the pre-, intra- and postoperative care of patients undergoing IONM.