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Intraoperative Neuromonitoring in Pediatric Surgery

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Monitoring the Nervous System for Anesthesiologists and Other Health Care Professionals

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Abstract

The use of intraoperative neurophysiological monitoring (IONM) in children was first described in 1979 (Neurosurgery 4(2):146–51, 1979), just 2 years after the first descriptions of the use of somatosensory evoked potentials (SSEPs) in adult spine surgery (Clin Orthop Rel Res 126:100–5, 1977). Since then, surgeons from many countries have integrated the use of IONM into the surgical care of pediatric patients. The modalities used and the types of procedures for which IONM is utilized have expanded greatly since 1979.

Today, the most common pediatric procedures, for which IONM is used, are those that may place the corticospinal and corticobulbar tracts, brainstem auditory pathways, dorsal columns, cranial nerves, and/or somatic nerve roots at risk of insult. These include anterior and posterior spinal fusions, tethered cord release, dorsal rhizotomies, resection of spinal cord tumors, craniotomies for certain tumors, and posterior fossa decompressions.

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Suggested Reading

  • Cornelissen L, Kim SE, Purdon PL, Brown EN, Berde CB. Age-dependent electroencephalogram (EEG) patterns during sevoflurane general anesthesia in infants. eLife. 2015;4:e06513.

    Article  PubMed  PubMed Central  Google Scholar 

  • Journee HL, Polak HE, De Kleuver M. Conditioning stimulation techniques for enhancement of transcranially elicited evoked motor responses. Clin Neurophysiol. 2007;37(6):423–30.

    Article  Google Scholar 

  • Lips J, de Haan P, de Jager SW, Vanicky I, Jacobs MJ, Kalkman CJ. The role of transcranial motor evoked potentials in predicting neurologic and histopathologic outcome after experimental spinal cord ischemia. Anesthesiology. 2002;97(1):183–91.

    Article  PubMed  Google Scholar 

  • McIntyre IW, Francis L, McAuliffe JJ. Transcranial motor evoked potentials are more easily acquired than somatosensory evoked potentials in children less than 6 years of age. Anesth Analg. 2016;122(1):212–8.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Anesthesiology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA

    Lisa Francis D.O., Veronica Busso M.D. & John J. McAuliffe M.D., M.B.A., D.A.B.N.M.

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  1. Lisa Francis D.O.
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  2. Veronica Busso M.D.
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  3. John J. McAuliffe M.D., M.B.A., D.A.B.N.M.
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Correspondence to John J. McAuliffe M.D., M.B.A., D.A.B.N.M. .

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Editors and Affiliations

  1. Departments of Anesthesiology, Neurological Surgery and Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA

    Antoun Koht

  2. Department of Anesthesiology, University of Colorado School of Medicine, Aurora, Colorado, USA

    Tod B. Sloan

  3. Department of Anesthesiology, Rush University Medical Center, Chicago, Illinois, USA

    J. Richard Toleikis

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Francis, L., Busso, V., McAuliffe, J.J. (2017). Intraoperative Neuromonitoring in Pediatric Surgery. In: Koht, A., Sloan, T., Toleikis, J. (eds) Monitoring the Nervous System for Anesthesiologists and Other Health Care Professionals. Springer, Cham. https://doi.org/10.1007/978-3-319-46542-5_43

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