By Aatif M. Husain MD
A realistic method of Neurophysiologic Intraoperative tracking covers all elements of neurophysiologic intraoperative tracking (NIOM), that is more and more getting used to continually investigate the practical integrity of a sufferers apprehensive method in the course of surgical procedure. With education in NIOM seldom on hand in conventional courses, this ebook is the one functional resource for crucial details at the scientific perform of NIOM. The e-book is split into handy sections: part One, simple rules, covers the modalities utilized in tracking in addition to the hardly ever mentioned themes of distant tracking, billing, moral concerns, and a buyer's consultant for constructing a laboratory. part studies anatomy, body structure, and surgical procedure of many of the methods, through information of the tracking modalities and their interpretive standards. particular gains comprise: Portability, effortless to hold and use contains all significant kinds of surgical procedures for which NIOM is asked details on procuring, education, set-up, and billing that's not on hand wherever else a different technical part on the finish of every bankruptcy that experiences the logistics of tracking a selected kind of surgical procedure valuable for trainees and skilled clinicians Value-priced at $75.00! With vast use of bullet issues, tables, and illustrations, this pocket-sized guide is key analyzing for neurologists, neuroanesthesiologists, neurosurgeons, and OR techs. (20100503)
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Extra resources for A PRACTICAL APPROACH TO NEUROPHYSIOLOGIC INTRAOPERATIVE MONITORING
2). Shape The shape of MUPs is largely determined by the distance and orientation of the MUP with respect to the recording electrodes coupled with the number of muscle fibers in the MUP. Some authors have tried to correlate the shape of the MUP with significance (multiphasic being more significant than monophasic), but this distinction is likely to be most useful in distinguishing artifact from MUP. When correctly identified, a monophasic MUP is likely to reflect recording from a distant muscle.
As a result, the undisturbed nerve is less likely to be irritated with minor manipulation than a nerve that has undergone nonaxonal damage. Once the axon itself is disrupted, that axon will not produce MUPs with proximal irritation (though the cut end of the distal portion of the axon may retain an ability to depolarize). Thus, as progressive axonal injury occurs, the nerve may once again show lesser degrees of EMG activity with manipulation proximal to the injury. This phenomenon is best illustrated when a nerve is subject to repetitive microtrauma, as with resection of neural tumors.
This was noted during microvascular decompression surgery for trigeminal neuralgia. After exposure, when the drill was no longer in use, the artifact disappeared. 10 The BrainLAB, which helps localize structures in the surgical field. until after the drilling has been completed. This is commonly seen in retromastoid craniotomies, such as those done for cerebellopontine angle surgeries. 11 Example of artifact caused by the operating table. Disconnecting the table eliminated the artifact. Preparing for a surgery in which monitoring will be used is among the most important things that the NIOM team does.
A PRACTICAL APPROACH TO NEUROPHYSIOLOGIC INTRAOPERATIVE MONITORING by Aatif M. Husain MD