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Evozierte Potentiale in der intraoperativen Überwachung

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Zusammenfassung

Die Reduktion operativ bedingter neurologischer Funktionsstörungen bei Eingriffen am zentralen Nervensystem ist ein geradezu historisches Bemühen der Neurochirurgen. Auch andere Fachrichtungen können im Rahmen ihrer Eingriffe mit einem neurologischen Ausfall konfrontiert werden: Rückenmarkläsionen bei Aortenchirurgie, Hörnervenausfälle bei kleinen Akustikusneurinomen in der Hals-Nasen-Ohren-Heilkunde, Hirninsulte bei der Karotischirurgie oder bei endovaskulären therapeutischen Eingriffen der Neuroradiologen. Mit der Einführung neuer Techniken in der Neurochirurgie (z. B. Mikroskop, Ultraschallsauger, Laser) kam es zu einer Verbesserung der operativen Resultate, gleichzeitig war die Ausdehnung in bisher nicht betretene Indikationsbereiche möglich geworden. Damit war der Bedarf für eine intraoperative Überwachung neurologischer Funktionen verstärkt gegeben. Erste Impulse zur intraoperativen Überwachung neurologischer Funktionen kamen von den Wirbelsäulenchirurgen, die den „Aufwachtest“ einführten. Ursprünglich wurden somatosensorisch evozierte Potentiale für das „intraoperative Neuromonitoring“ sensibler Bahnensysteme bei der Skoliosenchirurgie eingesetzt [18, 19, 25].

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Literatur

Übersichten

  1. 1.
    Møller A (1988) Evoked potentials in intraoperative monitoring. Williams & Wilkins, BaltimoreGoogle Scholar
  2. 2.
    Nuwer MR (1986) Evoked potential monitoring in the operating room. Raven, New YorkGoogle Scholar
  3. 3.
    Nuwer MR, Daube J, Fischer C, Schramm J, Yingling CD (1993) Neuromonitoring during surgery. Report of an IFCN committee. Electroenceph Clin Neurophys 87: 263–276CrossRefGoogle Scholar
  4. 4.
    Schramm J, Jones SJ (eds) (1985) Spinal cord monitoring. Springer, Berlin Heidelberg New York TokyoGoogle Scholar
  5. 5.
    Schramm J, Kurthen M (1992) Recent developments in neurosurgical spinal cord monitoring. Paraplegia 30: 263–276CrossRefGoogle Scholar

Anästhesiologie

  1. 6.
    Frazier WT (1994) Anaesthetic requirements for spinal surgery and effective cord monitoring. In: Jones et al. (eds) Handbook of spinal cord monitoring. Kluwer Academic, Dordrecht Boston London, pp 44–58CrossRefGoogle Scholar
  2. 7.
    Hume AL, Durkin MA (1986) Central and spinal somatosensory conduction times during hypothermic cardiopulmonary bypass and some observations on the effect of fentanyl and isoflurane anesthesia. Electroencephalogr Clin Neurophysiol 65: 46–58PubMedCrossRefGoogle Scholar
  3. 8.
    McPherson RW, Mahla M, Johnson R, Traystman RJ (1985) Effects of enflurane, isoflurane and nitrous oxide on somatosensory evoked potentials during fentanyl anesthesia. Anesthesiology 62: 626–633PubMedCrossRefGoogle Scholar
  4. 9.
    Pathak KS, Brown RH, Cascorbi HF, Nash CL (1984) Effects of fentanyl and morphine on intraoperative somatosensory cortical evoked potentials. Anaesth Analg 63: 833–837CrossRefGoogle Scholar
  5. 10.
    Prevec T (1980) Effect of valium on the somatosensory evoked potentials. Prog Clin Neurophysiol 7: 311–318Google Scholar
  6. 11.
    Russ W, Thiel A, Gerlach H, Hempelmann G (1985) Die Wirkung von Lachgas and Halothan auf somatosensorisch evozierte Potentiale nach Stimulation des Nervus medianus. Anaesth Intensivth Notfallmed 20: 186–192CrossRefGoogle Scholar
  7. 12.
    Samra SK, Lilly DJ, Rush NL, Kirsch MM (1984) Fentanyl anesthesia and human brainstem auditory evoked potentials. Anesthesiology 61: 261–265PubMedCrossRefGoogle Scholar
  8. 13.
    Sebel PS, Flynn PJ, Ingram DA (1984) Effect of nitrous oxide on visual, auditory and somatosensory evoked potentials. Br J Anaesth 56: 1403–1407PubMedCrossRefGoogle Scholar
  9. 14.
    Sloan TB, Koht A (1985) Depression of cortical somatosensory evoked potentials by nitrous oxide. Br J Anaesth 57: 849–852PubMedCrossRefGoogle Scholar
  10. 15.
    Taniguchi M, Nadstawek J, Pechstein U, Schramm J (1992) Total intravenous anesthesia for improvement of intraoperative monitoring of somatosensory evoked potentials during aneurysm surgery. Neurosurgery 31: 891–897PubMedCrossRefGoogle Scholar
  11. 16.
    Thurner F, Schramm J, Romstöck J, Pasch T (1987) Wirkung von Fentanyl and Enfluran auf sensorisch evozierte Potentiale des Menschen in Flunitrazepam/ N2O-Basisnarkose. Anaesthesist 36: 548–554PubMedGoogle Scholar

SEP

  1. 17.
    Brown RH, Nash CL Jr (1985) The „grey zone“ in intraoperative S. C. E. P. monitoring. In: Schramm J, Jones SJ (eds) Spinal cord monitoring. Springer, Berlin Heidelberg New York Tokyo, pp 179–185CrossRefGoogle Scholar
  2. 18.
    Brown RH, Nash CL Jr (1985) Intraoperative somatosensorisch evozierte kortikale Potentiale bei spinalen Operationen. In: Schramm J (Hrsg) Evozierte Potentiale in der Praxis. Springer, Berlin Heidelberg New York Tokyo, S 153–182CrossRefGoogle Scholar
  3. 19.
    Dinner DS, Luders H, Lesser RP, Morris HH, Barnett G, Klem G (1986) Intraoperative spinal somatosensory evoked potential monitoring. J Neurosurg 65: 807–814PubMedCrossRefGoogle Scholar
  4. 20.
    Gonzalez EG, Hajdu M, Keim H, Brand L (1984) Quantification of intraoperative somatosensory evoked potential. Arch Phys Med Rehabil 65: 721–725PubMedGoogle Scholar
  5. 21.
    Hacke W, Hündgen R, Zeumer H, Ferbert A, Buchner H (1985) Überwachung der therapeutischen neuroradiologischen Untersuchungs-und Therapieverfahren mittels evozierten Potentialen. Z EEG EMG 16: 93–100Google Scholar
  6. 22.
    Jones SJ, Carter L, Edgar MA, Morley T, Ransford AO, Webb PJ (1985) Experience of epidural spinal cord monitoring in 410 cases. In: Schramm J, Jones SJ (eds) Spinal cord monitoring. Springer, Berlin Heidelberg New York Tokyo, pp 215–220CrossRefGoogle Scholar
  7. 23.
    Koht A, Sloan T, Ronai A, Toleikis JR (1985) Intraoperative deterioration of evoked potentials during spinal surgery. In: Schramm J, Jones SJ (eds) Spinal cord monitoring. Springer, Berlin Heidelberg New York Tokyo, pp 161–166CrossRefGoogle Scholar
  8. 24.
    Little JR, Lesser RP, Lüders H (1987) Electrophysiological monitoring during basilar aneurysm operation. Neurosurgery 20: 421–427PubMedCrossRefGoogle Scholar
  9. 25.
    Maccabee PJ, Levine DB, Pinkhasov EI, Cracco RQ, Tsairis P (1983) Evoked potentials recorded from scalp and spinous processes during spinal column surgery. Electroencephalogr Clin Neurophysiol 56: 569–582PubMedCrossRefGoogle Scholar
  10. 26.
    Mc William RC, Conner AN, Pollock JCS (1985) Cortical somatosensory evoked potentials during surgery of scoliosis and coarctation of the aorta. In: Schramm J, Jones SJ (eds) Spinal cord monitoring. Springer, Berlin Heidelberg New York Tokyo, pp 167–172CrossRefGoogle Scholar
  11. 27.
    Macon JB, Poletti CE, Sweet WH, Ojemann RG, Zervas N (1982) Conducted somatosensory evoked potentials during spinal surgery, Part 2: Clinical applications. J Neurosurg 57: 354–359PubMedCrossRefGoogle Scholar
  12. 28.
    Narayan PV, Gilmour MP, Lloyd AJ, Dahn MS, King SD (1985) An assessment of the variability of early scalp-components of the somatosensory evoked response in uncomplicated, unshunted carotid endarterectomy. Clin Electroencephal 3: 157–160Google Scholar
  13. 29.
    Nuwer MR, Carlson LG (1994) A multicentre survey of spinal cord monitoring outcome. In: Jones et al. (eds.) Handbook of spinal cord monitoring. Kluwer Academic, Dordrecht Boston London, pp 78–87CrossRefGoogle Scholar
  14. 30.
    Russ W, Krummholz W (1984) Monitoring in der Carotischirurgie mit somatosensorisch evozierten Potentialen (SEP). Anaesthesist 33: 475Google Scholar
  15. 31.
    Ryan TP, Britt RH (1985) Spinal and cortical somatosensory evoked potential monitoring during corrective spinal surgery with 108 patients. Spine 11: 352–361CrossRefGoogle Scholar
  16. 32.
    Schramm J, Romstöck J, Thurner F, Fahlbusch R (1985) Variance of latencies and amplitudes in SEP monitoring during operation with and without cord manipulation. In: Schramm J, Jones SJ (eds) Spinal cord monitoring. Springer, Berlin Heidelberg New York Tokyo, pp 186–196CrossRefGoogle Scholar
  17. 33.
    Schramm J, Romstöck J, Watanabe E (1986) Intraoperatives Rückenmarkmonitoring: Eigene Ergebnisse und Bestandsaufnahme. Z Orthopäd 124: 671–782CrossRefGoogle Scholar
  18. 34.
    Schramm J, Koht A, Schmidt G, Pechstein U, Taniguchi M, Fahlbusch R (1990) Surgical and electrophysiological observations during clipping of 134 aneurysms with evoked potential monitoring. Neurosurgery 26: 61–70PubMedCrossRefGoogle Scholar
  19. 35.
    Schramm J, Zentner J, Pechstein U (1994) Intraoperative SEP monitoring in aneurysm surgery. Neurol Res 16: 20–22PubMedGoogle Scholar
  20. 36.
    Stechison MT, Panagis SG, Reinhart SS (1995) Somatosensory evoked potential monitoring during spinal surgery. Acta Neurochir (Wien) 135: 56–61CrossRefGoogle Scholar
  21. 37.
    Wang AD, Cone J, Symon L, Costa E, Silva JE (1984) Somatosensory evoked potential monitoring during the management of aneurysmal SAH. J Neurosurg 60: 264–268PubMedCrossRefGoogle Scholar
  22. 38.
    Young W, Berenstein A (1985) Somatosensory evoked potentials monitoring of intraoperative procedures. In: Schramm J, Jones SJ (eds) Spinal cord monitoring. Springer, Berlin Heidelberg New York Tokyo, pp 197–203CrossRefGoogle Scholar

AEP

  1. 39.
    Friedman WA, Kaplan BJ, Gravenstein D, Rhoton AL Jr (1985) Intraoperative brainstem auditory evoked potentials during posterior fossa microvascular decompression. J Neurosurg 62: 552–557PubMedCrossRefGoogle Scholar
  2. 40.
    Grundy BL, Jannetta PJ, Procopio PT, Lina A, Boston JR, Doyle E (1982) Intraoperative monitoring for brainstem auditory evoked potentials. Neurosurg 57: 674–681CrossRefGoogle Scholar
  3. 41.
    Hacke W, Berg-Dammer E, Zeumer H (1982) Evoked potential monitoring during acute occlusion of the basilar artery and selective local thrombolytic therapy. Arch Psychiatr Nervenkr 232: 541–548CrossRefGoogle Scholar
  4. 42.
    Hacke W, Buchner H, Ferbert A, Zeumer H, Böcker G (1985) Evoked potential monitoring during interventional neuroradiology: Experimental aspects of special catheter techniques. In: Schramm J, Jones SJ (eds) Spinal cord monitoring. Springer, Berlin Heidelberg New York Tokyo, pp 204–214CrossRefGoogle Scholar
  5. 43.
    Ojemann RG, Levine RA, Montgomery WM, McGraffigan P (1984) Use of intraoperative auditory evoked potentials to preserve hearing in unilateral acoustic neuroma removal. J Neurosurg 61: 938–948PubMedCrossRefGoogle Scholar
  6. 44.
    Raudzens PA, Shetter AG (1982) Intraoperative monitoring of brainstem auditory evoked potentials. J Neurosurg 57: 341–348PubMedCrossRefGoogle Scholar
  7. 45.
    Schramm J, Watanabe E, Strauss C, Fahlbusch R (1989) Neurophysiologic Monitoring in Posterior Fossa Surgery I. Technical Principles, Applicability and Limitations. Acta Neurochir (Wien) 98: 9–18CrossRefGoogle Scholar
  8. 46.
    Watanabe E, Schramm J, Strauss C, Fahlbusch R (1989) Neurophysiologic Monitoring in Posterior Fossa Surgery II. BAEP Waves I and V and Preservation of Hearing. Acta Neurochir (Wien) 98: 118–128CrossRefGoogle Scholar

VEP

  1. 47.
    Albright LA, Sclabassi RJ (1985) Cavitron ultrasonic surgical aspirator and visual evoked potential monitoring for chiasmal gliomas in children. J Neurosurg 63: 138–140PubMedCrossRefGoogle Scholar
  2. 48.
    Allen A, Starr A, Nudleman K (1981) Assessment of sensory function in the operating room utilizing cerebral evoked potentials. A study of fifty-six surgically anesthetized patients. Clin Neurosurg 28: 457–482PubMedGoogle Scholar
  3. 49.
    Cedzich C, Schramm J, Fahlbusch R (1987) Are flashevoked visual potentials useful for intraoperative monitoring of visual pathway function? Neurosurgery 21: 709–715PubMedCrossRefGoogle Scholar
  4. 50.
    Costa E, Silva J, Wang AD, Symon L (1985) The application of flash visual evoked potentials during operations on the anterior visual pathways. Neurol Res 7: 11–16Google Scholar
  5. 51.
    Feinsod M, Auerbach E (1971) The electroretinogram and the visual evoked potentials in two patients with tuberculum sellae meningioma before and after decompression of the optic nerve. Ophthalmologica 163: 360–368PubMedCrossRefGoogle Scholar
  6. 52.
    Raudzens PA (1982) Intraoperative monitoring of evoked potentials. Ann NY Acad Sci 388: 308–326PubMedCrossRefGoogle Scholar

MEP

  1. 53.
    Berger MS, Cohen WA, Ojemann GA (1990) Correlation of motor cortex brain mapping data with magnetic resonance imaging. J Neurosurg 72: 383–387PubMedCrossRefGoogle Scholar
  2. 54.
    Boyd SG, Rothwell JC, Cowan JMA, Webb PJ, Morley T, Asselman P, Marsden CD (1986) A method of monitoring function in corticospinal pathways during scoliosis surgery with a note on motor conduction velocities. J Neurol Neurosurg Psychiat 49: 251–257PubMedCrossRefGoogle Scholar
  3. 55.
    Ebeling U, Schmid UD, Reulen HJ (1989) Tumor-surgery within the central motor strip: Surgical results with the aid of electrical motor cortex stimulation. Acta Neurochir (Wien) 101: 100–107CrossRefGoogle Scholar
  4. 56.
    Inghilleri M, Berardelli A, Cruccu G, Priori A, Manfredi M (1990) Motor potentials evoked by paired cortical stimuli. Electroenceph Clin Neurophys 77: 382–389CrossRefGoogle Scholar
  5. 57.
    Jellinek D, Jewkes D, Symon L (1991) Noninvasive intraoperative monitoring of motor evoked potentials under propofol anesthesia: Effects of spinal surgery on the amplitude and latency of motor evoked potentials. Neurosurgery 29: 551–557PubMedCrossRefGoogle Scholar
  6. 58.
    Kalkman CJ, Ubags LH, Been HD, Swaan A, Drummond JC (1995) Improved amplitude of myogenic motor evoked responses after paired transcranial electrical stimulation during sufentanil/nitrous oxide anesthesia. J Anesthesiol 83: 270–276CrossRefGoogle Scholar
  7. 59.
    Pechstein U, Cedzich C, Nadstawek J, Schramm J (1996) Transcranial high frequency repetitive electrical stimulation for recording myogenic motor evoked potentials under general anesthesia. Neurosurgery 39 (in press)Google Scholar
  8. 60.
    Schmid UD, Boll J, Liechti S, Schmid J, Hess CW (1992) Influence of some anesthetic agents on muscle responses to transcranial magnetic cortex stimulation: A pilot study in humans. Neurosurgery 30: 85–92PubMedCrossRefGoogle Scholar
  9. 61.
    Taniguchi M, Cedzich C, Schramm J (1993) Modification of cortical stimulation for motor evoked potentials under general anesthesia. Technical description. Neurosurgery 32: 219–226PubMedCrossRefGoogle Scholar
  10. 62.
    Taniguchi M, Nadstawek J, Langenbach U, Bremer F, Schramm J (1993) Effects of four intravenous anesthetic agents on motor evoked potentials elicited by magnetic transcranial stimulation. Neurosurgery 33: 407–415PubMedCrossRefGoogle Scholar
  11. 63.
    Thompson PD, Day BL, Crockard HA, Calder I, Murray NMF, Rothwell JC, Marsden CD (1991) Intraoperative recording of motor tract potentials at the cervico-medullary junction following scalp electrical and magnetic stimulation of the motor cortex. J Neurol Neurosurg Psychiat 54: 618–623PubMedCrossRefGoogle Scholar
  12. 64.
    Zentner J (1989) Non-invasive motor evoked potential monitoring during neurosurgical operations on the spinal cord. Neurosurgery 24: 709–712PubMedCrossRefGoogle Scholar
  13. 65.
    Zentner J, Ebner A (1989) Nitrous oxide suppresses the electromyographic response evoked by electrical stimulation of the motor cortex. Neurosurgery 24: 60–62PubMedCrossRefGoogle Scholar

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