RT Book, Section
A1 Gordon, Errol
A1 Claassen, Jan
A2 Lee, Kiwon
SR Print(0)
ID 1101643387
T1 Evoked Potentials in the Operating Room and ICU
T2 The NeuroICU Book
YR 2012
FD 2012
PB McGraw-Hill Education
PP New York, NY
SN 9780071636353
LK neurology.mhmedical.com/content.aspx?aid=1101643387
RD 2024/04/19
AB Evoked  potentials  are  well  established  as  diagnostic  and  monitoring  tools  in  the  operating  room  (OR)  as  well  as  the  intensive  care  unit  (ICU)  setting.  They  may  help  clinicians  to  detect  injury  to  peripheral  nerves  and  the  spinal  cord  during  surgery,  and  help  prognosticate  outcome  after  traumatic  brain  injury  (TBI)  and  cardiac  arrest.A  55-year-old  woman  complained  for  several  years  of  neck  stiffness  and  pain  for  which  she  was  medicating  herself  with  nonsteroidal  anti-inflammatory  drugs.  Over  the  past  several  months,  she  noted  having  more  difficulty  getting  around  and  increasing  clumsiness.  She  denied  any  bowel  or  bladder  symptoms.  Her  examination  revealed  increased  tone  in  all  of  her  extremities  with  bilateral  positive  Babinski  signs  and  sustained  ankle  clonus.  Strength  was  full  power  on  confrontation  testing  throughout.  No  sensory  level  was  appreciated.  Her  primary  care  physician  sent  her  for  a  computerized  tomographic  (CT)  scan  of  the  cervical  spine,  which  revealed  significant  spondylosis  and  canal  stenosis  that  was  worse  at  C5-C6  and  C6-C7,  with  posteriorly  displaced  discs.  A  cervical  magnetic  resonance  image  (MRI)  revealed  cord  compression  with  cord  signal  changes  at  C5-C6.  After  getting  these  results,  the  primary  care  physician  referred  her  to  a  local  orthopedic  surgeon  who  recommended  decompression  of  C5-C6  and  C6-C7.  He  mentioned  that  he  will  be  using  intraoperative  neurophysiologic  monitoring  during  the  case.